Counseling Survey - Shelter From the Rain Inc.

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COUNSELING SURVEY

* Indicates required field

Parent's Name *

First

Last

Phone Number *

Email *

Ethnicity *

Black or African American White Asian American Indian or Alaska Native Native Hawaiian or Pacific Islander Multiple Ethnicity/ Other

If other, please specify: *

Total Number of Children: *

How many counseling sessions have you completed? *

On a scale of 1-5, how helpful were your counseling sessions? *

Option 1 - Not helpful at all Option 2- Somewhat helpful Option 3 - Helpful Option 4 - Very helpful Option 5 - Extremely helpful

How was this overall counseling experience for you (or your child)? *

Have you seen any progress since beginning these sessions? *

Yes No

What types of improvements have you seen in yourself or your child? *

What specific improvements have you seen during this process? Please check all that apply: *

Confidence Improvements Self-Esteem Improvements Academic Improvements Performance Improvements Learning Improvements Attitude Improvements Social Skill Improvements Productivity Improvements Quality of Life Improvements General Mental Health Improvements Decision-Making Improvements Grief, Depression or Anxiety Improvements Stress Management Improvements Problem-Solving and Conflict Resolution Improvements Behavior and Emotion Management Improvements

What did you enjoy most about this experience? *

What did you dislike about this experience? *

Any additional comments or suggestions? *

Submit

Shelter From the Rain Inc
Main Diaper Bank: 2203 Abercorn Street, Savannah, GA 31401
Mailing Address: P.O. 24195, Savannah, GA 31403
[email protected] | 912.232.5860

EIN: 37-1608228 | 501c3 Paperwork | W9 | Brand Guidelines

© 2024-2026 Shelter From the Rain Inc. | Website Donated By: FreshWorks Media

Home
About
Volunteer
- Internship
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Team
Resources
- Help For Home
- School Supplies
Events
Nominate!
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