Campus Counseling Center

Evaluation of Counseling Services

1. How did you rate your original concern that brought you to counseling? 
   Select One 1 - Little concern 2 3 4 5 6 7 8 9 10 - Significant Concern
   Comments: 
   
   
2. How would you rate this concern/problem now? 
   Select One 1 - Little Concern 2 3 4 5 6 7 8 9 10 - Significant Concern
   Comments:
   
   
3. Has counseling helped you?
   Select One Yes No
   
   Please explain:
   
   
4. What would you change about your counseling experience?
   
   
5. Please rate your counselor 
   Select One 1 - poor 2 3 4 5 6 7 8 9 10 - excellent
   
   
6. Name of your Counselor: 
7. What was your original problem/concern? Check all that apply.
   1. Depression Depression
   2. Anxiety Anxiety
   3. Eating Disorder Eating Disorder
   4. Relationship Problem Relationship Problem
   5. Childhood Abuse Childhood Abuse
   6. Stress Stress
   7. Other Other
   If other, please specify:
   
   
8. How many visits did you have and how often?
   
   
9. Any additional comments are welcomed: