Client feedback form

Please complete relevant sections.

Your Name:

Email:

Phone number:

How would you like the contents of this form to be used?
SelectPrivate and confidential feedback onlyI wish to be contactedPublicly posted anonymous reviewPublicly posted review with my name and likenessPublicly posted review with my name and likeness and usable in promotion and advertisingPublic review and I would like to be contacted for a video review

*A review will only be posted if submitted by a current or former client of Mind Relaxation Australia, or a valid representative of that client

What complaints and criticisms do you have (if any) and how can we improve our service?

Please describe your experience receiving treatment from us and benefits or detrimental effects experienced:

Based on your experience, would you recommend people struggling with feelings of anxiety, depression or destructive thought patterns try Mind Relaxation Australia and what would you say to them?

Where would you rate us between 1 and 5 stars?
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