Client Feedback Form

First Name *

Last Name *

Email *

Phone

Name of Practitioner *

Nicki Ritchie

Jada Rohovich

Service Performed *

How would you describe the look and feel of the Healing Space? *

Was the Practitioner personable and relatable? *

Were you provided self-care practices to do at home? *

Yes

Did you follow through with the recommended self care practices? *

How did you find the self-care practices? *

Valuable

Beneficial

Helpful

Unsure

No opinion, as I didn't do them

Disliked them

Not valuable, helpful, or beneficial

Not Applicable

What did you value or like most about the session(s)? *

Have you seen an improvement in your life since your treatment? If so, in what ways? *

Do you have any suggestions of how we could improve? *

Testimonial

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