Name
*
First Name
Last Name
Email Address
*
Phone
*
(###)
###
####
What was the response time after your initial contact with HOPE?
*
Within 24-48 hours
Longer than 24-48
How would you describe your initial conversation with the HOPE Scheduler?
*
What was your impression of the Counseling room?
Approximately, how many sessions did you have with your counselor?
*
1-3
4-6
7-9
10-13
14-17
18-21
22-25
26-30
More than 30
How often was prayer apart of your meetings?
*
Every Session
Occasionally
Rarely
Never
Was the Bible used frequently in your sessions?
*
Always
Usually
Rarely
Never
Were you expected to bring your Bible to the sessions?
*
Always
Usually
Rarely
Never
How often did you have to read the Bible in a counseling session or listen to your counselor read it to you?
*
Every Session
Occasionally
Rarely
Never
Were you encouraged by your counselor (the importance of) and to participate in a local church fellowship?
*
Frequently
Occasionally
Rarely
Never
Was the Gospel of Jesus Christ shared with you (The impact of Sin on us and how Jesus provides a solution to our problem with Sin) in a counseling session?
*
Frequently
Occasionally
Rarely
Never
How frequently were your sessions re-scheduled due to the counselor’s conflicts?
*
Frequently
Occasionally
Rarely
Never
How many sessions did you miss due to your conflicts, not the counselor's?
0
1-3
4-6
7-9
more
Was the counselor ever late for a session?
Frequently
Occasionally
Rarely
Never
Were you regularly given homework assignments?
*
100% of the time
75% of the time
50% of the time
Less than 50%
Going forward, do you feel like you have a reasonable plan and tools on how to address your struggles without the help of the counselor?
*
Yes, absolutely!
I feel like this process has given me one or two tools
I am basically in the same place as when I started
I am fairly confident
Please rate your overall experience with the HOPE counseling Center 1-10 (1 = Worst Counseling Experience I Can Imagine, 10= Incredibly Helpful! Highly Recommend!)
*
1
2
3
4
5
6
7
8
9
10
What was the professionalism of the counselor like in your opinion?
*
Do you feel that your presenting issues were addressed? If so, how?
*
Did you feel understood and listened to? If so, in what specific ways?
Have you gone for counseling anywhere else in the past? If so, how would you compare your experience at HOPE?
*
What are ONE or Two things that you think we should know that would help us become better at counseling others?
*
What are ONE or Two things you think we do with excellence?
*
Would you refer or recommend a friend for counseling here? Why or Why not.
*
If you feel that you have been helped, would you consider making a financial donation, of any amount, to our ministry so that we can continue to provide counseling to others?
*
Yes, contact me and share how I can make a donation.
No, I would not like to make a donation at this time.
Would you be willing to be added to our Ministry Newsletter and read news, blog posts, updates and financial needs.
*
Yes, include me on the mailing list!
No, I'd rather not be on the mailing list.
