Session Evaluation

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Enter date of your session

Select your counsellor

Glendon Wiebe	Carolyn Palfrey Scherer	Laurie Minuk
Derrick Doige	Susan Cawsey

Please type your name.

Please enter your email address if you would like this session evaluation form emailed to you.

Enter a valid email address. Example: name@company.com

On a scale from Zero (0) to Ten (10), with zero representing "not at all" and 10 representing "completely or entirely", please rank the following four statements regarding the session with your counsellor today. Please note that you can use decimals in your response if you wish (i.e., 5.6 or 7.2).

I felt heard, understood and respected

We worked on and talked about what I wanted to work on and talk about.

The counsellor's approach is a good fit for me.

Overall, today's session was right for me.

If you wish, please write a brief summary of the key issues discussed today.

This session evaluation form was adapted from the Institute for the Study of Therapeutic Change (Miller, Duncan & Johnson).