Review form

If you are a current client undergoing therapy with me, the form below enables me to assist you in your ongoing support. Please complete as best you can – if you are unsure of the answer please write “n/a”.

You are able to edit your answers if required. Many thanks for your participation, all responses are kept strictly confidential.


An essential part of my service is monitoring and evaluating of the service I provide, to ensure that highest possible standards are maintained. Your views are valued. For this reason, when you end counselling I would like to ask you to complete an anonymous feedback form. Your co-operation is much appreciated. No personal information is ever disclosed and participation is entirely voluntary.