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We value your opinion and we want to know how we can serve you better. The information you provide on this survey will be held in confidence.
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Please provide the name of the counsellor you saw:
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Please provide the name of who referred you to Kells:
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Are you accessing your EFAP provided through ASBA?
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5
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Please select your level of agreement with the following statements.
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Strongly Disagree | 2
Disagree | 3
Neutral | 4
Agree | 5
Strongly Agree | N/A
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| I was treated in a courteous manner by the reception staff. |
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| I was scheduled an appointment in a timely manner. |
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| I trust that my confidentiality will be maintained by Kells staff. |
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| I trust that my confidentiality will be maintained by my counsellor. |
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| The office space of my counsellor was comfortable. |
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| I feel that my counsellor provided me with helpful suggestions and strategies for dealing with my concern. |
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| My counsellor was understanding of my concerns. |
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| My counsellor was professional. |
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| I would recommend Kells to people I know. |
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| I am satisfied with the outcome of my visit(s). |
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| I would use Kells services again. |
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6
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Describe any concerns you have with your experience with Kells Counselling:
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7
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Describe any concerns you have with your experience with your counsellor:
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8
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Describe any positive experiences you had with Kells Counselling:
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9
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Describe any positive experiences you had with your counsellor:
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10
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If you would like a response to the comments you provided in this survey please provide your name and contact information:
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Thank you for taking your time to complete this survey.
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