JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Free2Talk Survey
Thank you for taking the time to complete the survey.
If you would like to donate to Essence of Mind, please do so via:
https://www.canadahelps.org/en/dn/45233
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Your Name:
*
Your answer
Name of your Volunteer Counsellor:
*
Your answer
How professional was your experience with Essence of Mind's Crisis Line, Free2Talk?
*
Unsatisfactory
1
2
3
4
5
Exceptional
Would you recommend or refer this service?
*
Absolutely Not
1
2
3
4
5
Definitely Yes
Would you please share some feedback about your counsellor and the manner in which they helped you today?
*
Your answer
Were you provided any additional resources or referrals?
*
Yes
No
Did you request a follow up call or would you like to receive one?
*
Yes
No
Maybe
Please choose all that apply. I identify as:
*
(Select all that apply)
Asian
Black/African
Caucasian
Hispanic/Latin
Native American
Pacific Islander
Prefer not to answer
Required
Additional Comments:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
