We would like your permission to carry out a psychological evaluation in the form of a short questionnaire. Before we begin, please read the information below.

What you are agreeing to:

1. Why we are doing this

We are collecting information to better understand your thoughts, feelings, and needs at the start and end of your counselling sessions. This can help guide support for you, or to inform future planning and funding of our support services.

2. Your information is private

Everything you share will be kept private and only shared with your counsellor – unless we are worried about your safety or someone else’s. In those cases, we may need to speak to someone else to help keep you safe.

3. How your data will be stored

All the information we collect will be stored safely, on a secure computer or storage server. Only authorised staff will be able to see it. We follow the law (UK GDPR and Data Protection Act 2018) to protect your information.

4. Using your information

Your information from this form is purely for the purpose of understanding and informing your counsellor of how you feel before you begin your counselling, and for the purpose of evaluation at the end of your counselling sessions. If we use your information to inform reports or funding applications, your name and personal details will never be included, so no one knows it’s you.

5. You can stop at any time

Taking part is your choice. You can say no or stop at any time, and you don’t have to explain why. You can also ask us to delete your information unless we have to keep it for legal reasons, or it has already been anonymised.

6. Ask questions if you need to

You can ask questions at any time about what we’re doing with your information and how we are keeping it safe.