Creative Therapy Evaluations – Child and Parent

Thank you for taking a few minutes to complete the following evaluation forms. Your feedback will help us get a better understanding of whether creative therapy is helpful and if so why

Please note the form is better viewed on a tablet or PC/Laptop rather than a Mobile device.

Creative Therapies Evaluation Form - Adult & Child

Page 1

Thank you for taking the time to complete our evaluation form for your child's recent creative therapy sessions. It is very important that you enter the unique Therapy evaluation ID we sent you via email in the field below, to help us log your form correctly.

Page 1 should be completed by the Adult and Page 2 should be completed by the child

Therapy evaluation ID

Please use the unique Therapy ID sent to you in our email. Please use the format "T-000001"

Child's details

First Name

Last Name

Parent/Carer details

First Name

Last Name

Relationship to child

Contact Phone

Whichever is your preferred number

Contact Email

Creative Therapy details

Type of Creative Therapy

Date of first session

Date of final session

Question 1

Do you feel the therapy has helped your child?

YesNoNot sure

Can you give us some examples/explain your answer above?

Question 2

Below is a list of statements, please could you score them in terms of your child after therapy.

	N/A	1 (poor)	2 (fair)	3 (good)	4 (very good)	5 (excellent)
Your child's understanding of the impact meningitis has had on themselves
Your child's ability to cope with the impact of meningitis
Your child's relationship with others e.g. school friends, teachers, family
Your child's behavioural skills
Your child's social skills
Your child's feelings of emotional well-being

Has the therapy had any effects on you or your family as a whole? If possible, please explain.

Question 3

Did the creative therapy sessions meet your expectations?

Met my expectationsExceeded my expectationsDidn't meet my expectations

If it didn't meet your expectations, can you explain why it didn't?

Question 4

How did we handle your request for therapy?

Very wellJust rightPoorly

If your answer was 'poorly', can you tell us what would have helped to improve the way we handled it?

Question 5

Anything else you would like to comment/feedback on?

Sharing your story

From time to time we appreciate being able to share the benefit you have felt from counselling after meningitis. Would you be willing to share your experience, eg case study, evaluation in our publications and on social media

Yes I give permission

Page 2

This section should be completed by the child who has received Creative therapy


Did you enjoy the sessions?
How much have the sessions helped?
How are you feeling in yourself?
How are things with your friends?
How are things at school?
Have you learnt new things?

The sessions helped me by

Contact Information