Dialogue Post Counselling Feedback:
from Child

Thank you for taking the time to fill out this form.
Name*
Child's First Name Child's Last Name
School*
Date*
DD slash MM slash YYYY
Things I liked about counselling
Anything else you’d like to tell us?
Anything you’d like to write about your counsellor?
Things I didn’t like about counselling
Counsellor's Email Address*
Due to privacy considerations ymcadlg.org addresses only please. Use of email addresses outside this domain will result in form information being lost.
We may use what you’ve put here to tell other people about counselling. We will never use your name.
Name
This field is for validation purposes and should be left unchanged.

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