Complete a separate form for each counselor with whom you had a session(s) between January 01, 2003 and today's date.
1.
Counselors
Rick Mason
Dianne Fain
Sandy Holbrook
Shelia Gordon
Ron Brunty
Please mark the appropriate box. A is the Highest rating. E is the Lowest rating. NA is No Opinion. DK is Don't Know.
The Counselor: FALL 1998
2.
Helped to make me feel at ease.
A
B
C
D
E
NA
DK
3.
Respected my thoughts and feelings.
4.
Tried to understand what I was saying.
5.
Was the sort of person to whom I could talk openly and freely.
6.
Took time to listen to me.
7.
Helped me with my problem(s).
8.
Provided information which was useful.
9.
Supported me in seeking solutions to my problems rather than solving them for me.
10.
Helped me to view personal issues in new ways.
11.
Was available when I needed to see him/her.
12.
COMMENTS AND SUGGESTIONS FOR IMPROVEMENT:
Thank You