Reiki consultation feedback
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1. FEEDBACK FORM

The purpose of this feedback form is to evaluate what you thought of the consultation you received, and to implement ways of improving them.

I would like to thank you for taking the time and effort in filling this out. For more information you may wish to visit the main website at www.empowermenthealing.com

Light and love,

Adam

1. What is your reason for receiving this consultation?

What is your reason for receiving this consultation? Reduce stress and anxiety

Improve concentration and memory

Improve performance in areas of life (such as work and study)

Increased stamina and vitality. More energy

Develop a more positive outlook on life

Develop a more positive attitude towards others

General health

Learn ways in how to help myself and/or others

Reduce the risk or symptoms of physical illness

Remove emotional blockages in my life

Improve my intuitive abilities

Find answers to questions of concern

All of the above

Not sure

Other (please specify)

2. How would you rate the following consultation?

	very poor		poor		moderate		good		very good	excellent
Overall performance	*How would you rate the following consultation? Overall performance very poor	Overall performance	Overall performance poor	Overall performance	Overall performance moderate	Overall performance	Overall performance good	Overall performance	Overall performance very good	Overall performance excellent
Presentation	Presentation very poor	Presentation	Presentation poor	Presentation	Presentation moderate	Presentation	Presentation good	Presentation	Presentation very good	Presentation excellent
Service delivery	Service delivery very poor	Service delivery	Service delivery poor	Service delivery	Service delivery moderate	Service delivery	Service delivery good	Service delivery	Service delivery very good	Service delivery excellent
Equipment used	Equipment used very poor	Equipment used	Equipment used poor	Equipment used	Equipment used moderate	Equipment used	Equipment used good	Equipment used	Equipment used very good	Equipment used excellent
Cost	Cost very poor	Cost	Cost poor	Cost	Cost moderate	Cost	Cost good	Cost	Cost very good	Cost excellent
Punctuality	Punctuality very poor	Punctuality	Punctuality poor	Punctuality	Punctuality moderate	Punctuality	Punctuality good	Punctuality	Punctuality very good	Punctuality excellent

3. How long did the consultation last for? If a time is not listed, please choose the closest one to it

How long did the consultation last for? If a time is not listed, please choose the closest one to it 0 mins (for absent/distant/emailed consultations)

15 mins

30 mins

60 mins

1 hr, 30 mins

2 hours

Not sure

4. Where was the consultation being delivered?

Where was the consultation being delivered? Academic institute (such as schools, TAFE’s and uni)

Work site

Private home

Community Centre

Public librarie

Expo

Gym

Esoteric store

Health food store

Market/fair

Social group

Online

Place of spiritual significance

Nature

All of the above

Other (please specify)

5. How did you find out about this consultation?

How did you find out about this consultation? Search engine (i.e Google)

Online directory

Magazine

Newspaper

Online advertisement

Word of mouth

Newsletter

Business card

Brochures

Radio

Mobile advertisement (i.e. clothing, car)

Other (please specify)

6. What did you enjoy about the consultation? How could these things be enhanced in the future?

What did you enjoy about the consultation? How could these things be enhanced in the future?

7. What did you not enjoy about the consultation? How could these things be improved in the future?

What did you not enjoy about the consultation? How could these things be improved in the future?

8. Anything else that should be added to this feedback form? Any comments or suggestions on how it could be improved?

Anything else that should be added to this feedback form? Any comments or suggestions on how it could be improved?

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Reiki consultation feedbackExit this survey >>

1. FEEDBACK FORM

1. What is your reason for receiving this consultation?

2. How would you rate the following consultation?

3. How long did the consultation last for? If a time is not listed, please choose the closest one to it

4. Where was the consultation being delivered?

5. How did you find out about this consultation?

6. What did you enjoy about the consultation? How could these things be enhanced in the future?

7. What did you not enjoy about the consultation? How could these things be improved in the future?

8. Anything else that should be added to this feedback form? Any comments or suggestions on how it could be improved?

Reiki consultation feedback
Exit this survey >>