Name of group facilitator*
Date* (DD/MM/YYYY)
Describe what the group facilitator did that you thought worked well. Be as descriptive as you can.*
What was the effect on the Group?*
What do you think the group facilitator could do differently?*
Did the group facilitator use any of the following?
Active Listening* YesNoN/A
Reflective Listening* YesNoN/A
Validating* YesNoN/A
Moving on questions* YesNoN/A
Eye Contact* YesNoN/A
Challenging* YesNoN/A
Self-Disclosure* YesNoN/A
Feedback* YesNoN/A
Negotiating Skills* YesNoN/A
Recapping* YesNoN/A
Resources* YesNoN/A
Any other comments?*
Group leaders email address* This is where your form will be sent, please check spelling
Your email address This is optional, please fill out if you wish to recieve a copy for your records.
