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Pertaining to you experience with the Counseling Center this semester please check all those that apply:

If you had NOT received Counseling Center services, how likely is it that you would have:

      Not at all likely Very unlikely Unlikely Uncertain Likely Very likely Definitely
   
   
   
   
   
   
   
   
   

Center Environment:
      Strongly Disagree Disagree Somewhat Disagree Neither Agree nor Disagree Somewhat Agree Agree Strongly Agree
   
   

Reception Staff:
      Strongly Disagree Disagree Somewhat Disagree Neither Agree nor Disagree Somewhat Agree Agree Strongly Agree
   
   

Intake Counselor:  Please write the name of the Counselor you saw at your first appointment:

Please rate the following:
      Strongly Disagree Disagree Somewhat Disagree Neither Agree nor Disagree Somewhat Agree Agree Strongly Agree
   
   
   
   
   
   
   

Individual or Couples Counseling:

Please rate the following:
      Strongly Disagree Disagree Somewhat Disagree Neither Agree nor Disagree Somewhat Agree Agree Strongly Agree
   
   
   
   
   
   

Group Counseling:

Please rate the following:
      Strongly Disagree Disagree Somewhat Disagree Neither Agree nor Disagree Somewhat Agree Agree Strongly Agree
   
   
   
   
   

Psychiatric Staff: (for medication)
      Strongly Disagree Disagree Somewhat Disagree Neither Agree nor Disagree Somewhat Agree Agree Strongly Agree
   
   
   
   
   
   

Overall ratings:
      Strongly Disagree Disagree Somewhat Disagree Neither Agree nor Disagree Somewhat Agree Agree Strongly Agree
   
   
   
   
   
   

Do you want a response to your written comments? (If so, please provide your name and phone number in the box above.)