Feedback form (Norwich)

1. Client satisfaction survey

At Sue Lambert Trust, we are always striving to improve our services. It would really help us if you could find the time to fill in this survey.
 

1. What services have you accessed at the Sue Lambert Trust? *

 

2. What was the name of your counsellor / support worker? *

 

3. Please circle the number which best indicates how you agree or disagree with each statement. *

Strongly agreeAgreeDisagreeStrongly disagreeNeither or N/A
I felt supported whilst I was on the waiting list for counselling
I felt listened to at the Sue Lambert Trust
Sue Lambert's staff and volunteers were professional
Sue Lambert's staff and volunteers were supportive and caring
I found the support offered by the Sue Lambert Trust helpful
I would use this service again if needed
I would recommend this service to a family member or friend
 

4. Did you find receiving support from the Sue Lambert Trust helped you in any of the following areas? *

YesNoNot relevant or applicable
Increased emotional wellbeing
Improved coping resources
Increased self-esteem
Improved day-to-day living (e.g. ability to carry out everyday tasks, sleeping)
Reduced suicidal thoughts or feel more able to manage these
Improved relationships with family and/or friends
Getting into/maintaining employment
Reduced use of other mental health services and/or hospital admissions
 

5. Finally, during your counselling you may have completed a form about how you were feeling. This final part of the form has 10 statements about how you have been OVER THE LAST WEEK. Please read each statement and think how often you felt that way last week. Then tick the box which is closest to this.

Please note that these forms are not processed every day and we are unable to identify individuals from these forms. Therefore, if you are feeling low and need some support then please remember there are people you can talk to such as the Samaritans (Tel: 116 123).

Over the last week ...

Not at allOnly occasionallySometimesOftenMost or all of the time
1) I have felt tense, anxious or nervous
2) I have felt I have someone to turn to for support when needed
3) I have felt able to cope when things go wrong
4) Talking to people has felt too much for me
5) I have felt panic or terror
6) I have made plans to end my life
7) I have had difficulty getting to sleep or staying asleep
8) I have felt despairing or hopeless
9) I have felt unhappy
10) Unwanted images or memories have been distressing me
 

6. If you have any other feedback, please use the box below. Thank you for taking the time to complete this form. Your feedback is very much appreciated.

Check out our survey templates or create your own.