Testimonial Form
It was a pleasure to work with you! If you'd be so kind, please use this testimonial form to provide feedback about your experience. Thank you!
Name
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First Name
Last Name
Business Name
Email
*
example@example.com
What challenge/issue/problem did you have? OR...What type of help were you looking for?
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What results did you experience from working with me? Did I help you address a specific challenge? If so, please describe how I helped, and be as specific as possible.
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How would you describe the experience of working with me?
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Would you recommend my services to your friends, family, clients, or others in your field? Why or why not?
*
Is there anything you'd like to add?
Please upload a photo (headshot) of yourself OR your business logo that I have permission use when I share your testimonial.
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Note About Testimonial Use
By clicking "Submit," you are agreeing to the following terms: You agree that I may publish your testimonial, together with your name and photo on this website (and on any successor website that I may operate from time to time), on such pages, print, and in such position, as I may determine in my sole discretion. You further agree that I may edit the testimonial and publish edited or partial versions of the testimonial. However, I will never edit a testimonial in such a way as to create a misleading impression of your views. You may terminate this license by giving me 30 days written notice of termination.
Type Name
E-Signature
Date
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Month
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Day
Year
Date
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