Personal Counselling Feedback Form

At Brock University we are committed to continuous improvement and as such, we invite you to provide feedback about your Personal Counselling experience.

*Please note that for quality assurance purposes, we do require your personal information; however,
your feedback will remain confidential within the limits of the law. If you have any questions or
concerns about this feedback form, please contact Samantha Morley smorley@brocku.ca.

  • Name * Required
  • What type of feedback are you providing? * Required
  • Have you received Personal Counselling service through the Brock Student Wellness and Accessibility Centre (SWAC)? * Required
  • How would you rate the quality of services you received from Personal Counselling? * Required
  • After your session, how would you rate your ability to cope with the issue that brought you to Personal Counselling? * Required
  • Based on your experience, would you refer a friend or family member of the Brock community to Personal Counselling services? * Required
  • Would you like someone from our department to follow up with you about your feedback? * Required
  • This field is for validation purposes and should be left unchanged.