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HFW Conference • EXALT 2019

Counseling Survey

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Counseling Survey

Counseling Survey

Help us to serve you and others by completing this brief survey of your experience with your chosen Hope for Wholeness's counselor.

HFW Counseling Survey

Was your counseling appointment a positive experience?
- Yes
- No
Did the appointment make you feel better or worse?
What was the date of your visit?
Date Format: MM slash DD slash YYYY
Was this your first visit?
- Yes
- No
Please explain.
When you initially called the office, was your phone call handled in a timely manner and professionally?
- Yes
- No
Please explain.
On a scale from 1-10, with 10 being the highest possible--Please rate your call-in and initial telephone experience.
The purpose of the counseling appointment was to help me with:
- Myself (I struggle personally)
- To help me with a family member who struggles
- To help me with a family member who is gay identified
- Other
Please explain.
Name of HFW staff member or HFW Referral that you met with:
Other--Name of HFW Referral that you met with:
How or where did you meet/speak?
- In-person, at the Hope for Wholeness office
- In-person, at my HFW Referral's office
- In-person, at my HFW counselor Referral's church
- Skpye or Phone
- Other
Did you communicate via Skype/Video conference or phone?
- Skype/Video conference
- Phone
Please explain.
Overall, did you feel the environment was comfortable and professional?
- Yes
- No
Please explain.
Do you feel your appointment was set in a timely manner?
- Yes
- No
Please explain.
What was the length of your appointment?
Did you feel this was an appropriate length of time considering your circumstances?
- Yes
- No
Please explain.
Would you consider/like to have (an) additional appointment(s) for help?
- Yes
- No
Please explain.
Did you feel the Intake Form for Counseling & Support that you submitted was clear and user friendly?
- Yes
- No
Please explain.
Do you feel the information you received was beneficial to why you initially set up an appointment?
- Yes
- No
Please explain.
On a scale from 1-10, with 10 being the highest possible--Please rate your counselors ability and knowledge to assist you in your situation.
Would you like to start a counseling relationship?
- I would like to start coming regularly (weekly to monthly)
- I would like to communicate with my counselor when I need help through texting, Facebook PM, phone, and/or email
- I would like to participate in any type of support group that may be offered
Do you believe and/or feel the staff and counselor were courteous, warm and trust-worthy?
- Yes
- No or not really
Please explain.
Did you feel comfortable sharing confidential information and concerns with the counselor?
- Yes
- No or not really
Please explain.
What do you feel was most helpful for you?
Was there anything that was unhelpful?
- Yes
- No
Please explain.
Do you feel you were given enough time to talk?
- Yes
- Yes, considering it was a first appointment
- No, not really
Please explain.
In initial appointments, there is an education process that takes up a lot of time. This can be done in (a) video presentation(s) prior to the appointment. Would you have preferred this?
- Yes
- No
Were there areas you felt you needed to discuss, but didn’t?
- Yes
- No
Please explain.
Do you feel your counselor gave you sufficiently biblically based views and support on coping with and/or overcoming your struggles that you can utilize?
- Yes
- No or not really
Please explain.
On a scale from 1-10, with 10 being the highest possible--Given the opportunity, how likely would you recommend our ministry based on your experience?
Are there any other comments you would like to share about your visit that would help us to improve?
What type of aftercare do you hope for and/or expect?
Please check all that apply. I plan to:
- Attend a support group as able and available
- Attend additional HFW social events as available
- Attend the HFW Conference next June at Ridgecrest, NC
- Call/text/Facebook PM, email for additional help
- Financially support Hope for Wholeness
- Financially support my local HFW Referral Ministry
- Join (or already participate) in the HFW Facebook groups
- Return for additional counseling help
Would you be willing to share a testimonial of your experience that we can use in publications and on our website? If you'd like to use your name and/or city/state, age, gender, etc., please put everything within this field. Nothing outside the field will be used. Thank you!
Would you be willing to share your name and contact information?
- Yes
- No
If you are willing to share your email, you will you receive a reply containing a copy of your submission.
Name
First Last
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Would you like us to contact you to discuss your answers and/or to set up your next appointment and getting more involved?
- Yes
- No
You MUST select YES to the above question "share your name and contact information" for us to be able to contact you.
How would you prefer to be contacted?
- Phone
- Email
- Text
- Facebook Private Message
What day/time is the best time to give you a call?
Email
This field is for validation purposes and should be left unchanged.

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