Client Feedback

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Name *

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Last

What were you struggling with when you first reached out for counseling? *

What have you gained or learned from our sessions together? *

How are you applying what you have learned to your life? *

How has your relationship with God changed or improved? *

Do you currently have any areas of struggle where you feel you could use more support? *

What do you like most about our sessions? *

What would make our sessions together more beneficial? *

What would you like to work on that we haven’t addressed yet? *

What piece of advice would you give others? *

If you have Facebook, are you interested in joining our private Facebook support group? *

Yes (provide link to your FB page below) No I don't have Facebook I already joined this group

Copy link to your Facebook page here so I can invite you to the group: *

May I use your responses to craft a testimonial to post on the website? *

Yes (you may also include my name) Yes (but do not include my name) No

Can this ministry do a "client spotlight piece" on you to share your success story with other members of the ministry's client base? If so, check below: *

Yes, and I would prefer to do a video spotlight piece Yes, and I would prefer to do a written spotlight piece Maybe, but would like more information No, not at this time

As a congratulations for all of your hard work, I would like to send you a Holistic Christian Therapies T-shirt! There are 4 styles to choose from. To view styles, click here. In the space below, type which shirt style, size, and color you want. Include the mailing address that you would like your shirt shipped to:

T-shirt style, size, color, and shipping address: *

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