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Sherig Counselling Services-Individual
Report form for Counselling provided by MoE Counsellors
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Email
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Your email
Month/Year
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Choose
January-2021
Feburary-2021
March-2021
April-2021
May-2021
June-2021
July-2021
August-2021
September-2021
October-2021
November-2021
December-2021
Client Type
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Choose
Student
Teacher
Parent
Caregiver
others
If others please specify what profession or category
Your answer
If Student, Please specify class ( eg. 6, 7 ,8, 12 etc- Stream not required)
Your answer
Age (Client)
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Your answer
Age Range (applicable only for students option 1-5) and CLICK others if the client is not a student)
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under 5 years
5-9 years
10-14 years
15-17 years
18 and above
Others (adults)
Sex (Client)
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Female
Male
Other:
Client Location
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Jakar
Chhukha
Phuentsholing
Daga
Gasa
Ha
Lhuntse
Mongar
Paro
Pemagatsel
Punakha
Samdrup Jongkhar thromdey
Samdrup Jongkhar
Samtse
Gelephu
Sarpang
Thimphu
Trashigang
Trashiyagtse
Trongsa
Tsirang Dzongkhag
Wangdue Phodrang
Zhemgang
Others-Please specify
If others-Please specify the country
Your answer
Client Issues
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Depression
Anxiety
Stress
Addiction
Family related issues
Child Protection Issues
others-specify in next column
Other Issues-Please specify the issue (one-two words)
Your answer
Counselling provided via (mode)
Choose
Facebook Messenger
Wechat
Whatsapp
Gmail
Mobile Text
Telegram
Mobile Voice call
Video Call
Face to Face
Others-please specify
If others-Please specify
Your answer
Session Length (in Minutes)-for eg. 15 etc
*
Your answer
Session Type
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New
Old
Case Status
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Ongoing
Completed
Referred to CECD
Referred to NCWC
Referred to RENEW
Referred to Hospital
Referred to BNCA
Referred to National/District MH focal persons
Others
If other referrals-Please specify
Your answer
Counselor Code
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Tang CS
Ura CS
Wangduecholing LS
Jakar HS
Chumey CS
Chabcha MS
Arekha MS
Chukha CS
Kamji CS
Chukha CS
Phuntsholimng HS
Phuntsholing LS
Pakshikha CS
Phuntsholing MS
Sonamgang MS
Wangchu MS
Gedu HS
Darla MS
Chumithang MS
Daga CS
Drukjeygang CS
Gesarling CS
Lhamoizingkha CS
Dagapela MS
Tsangkha MS
Bjishong CS
Chundu AFPS (CS)
Gongzim Ugyen Dorji CS
Katsho LS
Menji MS
Lhuntse HS
Autsho CS
Tangmachu CS
Mongar HS
Mongar MS
Gyelposhing CS
Yadi CS
Dramitse CS
Chaskar CS
Kidheykhar CS
Nagor CS
Kengkhar MS
Shaba HS
Drukgyel CS
Shari HS
Khangku MS
Lango MS
Betikha CS
Dawakha LS
Wanakha CS
Dotey LS
Gaupel LS
Woochu LS
Drukgyel LS
Nanglam CS
Nanglam CS
Pemagatsel MS
Nangkhor CS,
Yelchen CS
Yurung CS
Kabesa CS
Punakha CS
Dashiding HS
Dechentsemo CS
Khuru MS
Lobesa LS
Tashidingkha CS
S/Jongkhar MS
Garpawong MS
Gomdar CS
Minjiwong CS
Karmaling HS
Orong CS
Martshalla CS
Phuntshothang MS
Jomotsangkha CS
Dorokha CS
Samtse HS
Tendruk CS
Gomtu HS
Yoeseltse MS
Peljorling HS
Norbugang CS
Syndhen LS
Denchukha LS
Taba Damtoe LS
Sherubgatshel LS
Samtse LS
Sarpang CS
Choekorling LS
Sarpang MS
Norbuling CS
Dekiling MS
Gelephu MS
Gelephu HS
Pelrithang HS
Bayling CS
Tsenkharla CS
Kunzangling CS
Ramjar CS
Trashiyangtse LS
Jampeling CS
Gongthung MS
Rangjung CS
Tashitse HS
Thrimshing CS
Udzorong CS
Dungtse CS
Radhi MS
Bartsam CS
Trasgigang MS
Jigme Sherubling CS
Babesa HS
changzamtog MS
Changangkha MS
Zilkha MS
Lungtenzampa MS
Wangbama CS
Dechencholing HS
Yangchengatsel MS
Khasadrapchu CS
Motithang HS
Yangchenphug HS
Jigme Namgyal LS
Loselling MS
Lungtenphu MS
Kuzhugchen MS
Genekha LS
Taba LS
Langthel LS
Taktse CS
Tshangkha CS
Sherubling CS
Samcholing MS
Tserangtoe CS
Damphu CS
Mendrelgang CS
Damphu LS
Phobjekha CS
Samtengang CS
Gaselo CS
Bajo HS
Zhemgang CS
Zhemgang LS
Sonamthang CS
Yebilaptsa CS
Buli CS
CECD
Dorokha LSS
Chali LSS
Thimyul LSS
Tshaphel MSS
Thragom LSS
Yurung CS
Pemathang LSS
Khaling LSS
Sarpang CS
Nobding LSS
Daga Central School
Bumdeling LSS
Orong LSS
Pakshikha CS
Kheni LSS
Sakteng LSS
Kunzangling CS
Serzhong LSS
Bjibjokha LSS
Yangchenphug HSS
Jigmecholing MSS
Jangchubling MSS
Bartsam CS
Khoma LSS
Tsimalakha MSS
Bikhar LSS
Shengana LSS
Tashiding LSS
Lingmethang MSS
Umling MSS
Daleythang LSS
Counsellor Contact No.
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