Please use this client satisfaction survey form to provide your opinions and feedback about the counselling services you are receiving at Cobb Counselling & Consulting and the progress you feel you are making. Your responses will help improve the quality of services you are receiving.
This client satisfaction survey is meant to be completed every three to four sessions. As with all client information, your responses will be kept strictly confidential. You do not need to provide your name or any identifying information other than your case ID number (you'll find it on your invoice) which allows me to identify you. When you hit the submit button your information will be stored on a secure server to which only I have access.
You are also free to complete this survey by
hardcopy
if you prefer. If you choose the hardcopy option, you can fax your completed survey to me at (403) 255-8570 (confidential fax) or you can bring it with you to your next session.
Please refer to the
privacy policy
for Cobb Counselling & Consulting if you have any questions about privacy and your personal information.
This form should take about 5-10 minutes to complete. You do not have to complete all of it before you submit it, but you do need to finish what you intend to submit in one sitting as you cannot save a partially completed form and come back to it later to continue working on it. If you close the browser window before hitting the submit button your information will be lost. If you would like to retain a copy, please print this page on your browser before you submit the survey.