Feedback
PURPOSE: For Personal reflection and to Help Us Better Serve You. Feedback should be completed within 12 hours of appointment; immediately following is even better. Thank you!
My Server:
Coach Paula
Overall Satisfaction of service (by phone? may need to tilt to sideways/landscape - should see 5 columns)
*
Very satisfied
Satisfied
Neutral
Unsatisfied
Very unsatisfied
Friendliness
Compatibility
Knowledge
Met my needs
Explained things well to me
I feel like this helped me
I feel heard
What I was feeling/experiencing before this session began?
*
(Example: hopeless, anxious, stuck, happy, sad, angry, confused, tired, in pain, stressed, etc.)
After working together I was feeling/experiencing:
*
What were the issues I/we identified during this session?
*
What insights did I have after working together?
*
What worked for me about this session was:
*
What didn't worked for me about this session was:
Would I be open to using this service again in the future?
Yes
No
Maybe
How valuable were the insights and breakthroughs I experienced today?
*
0 is no value, 10 is extreme value
This service could possibly be improved by ___________?
How can we improve to help you better?
I'd like to give a testimony to encourage others via written, audio and/or video (optional).
Overall, I find this service valuable enough to recommend to others.
0 is no value, 10 is extreme value
Comments/Questions
Name
*
First Name
Last Name
Email
*
example@example.com
Submit Feedback
Should be Empty: