Client Feedback and Testimonial Form
Please answer these questions as honestly as you can.This questionnaire serves three purposes.
- For you as a valued client. The feedback section provides you with the opportunity yo give Pollin any comments and feedback about her, her service and/or the effectiveness of the program she shared with you. Please feel free to express your view, values and concerns in a constructive way so that we can address issues or suggestions brought to our attention.
- For Pollin as a professional. Your truthfulness will help Pollin become aware of any areas that need attention so that she can continue to improve and provide the best level of service possible to all her clients. With your valuable feedback, Pollin will be able to determine if the standard of her service is up to your expectation.
- For public awareness. This feedback also functions as a testimonial to be used on Pollin's website, digital platforms and/or educational and marketing materials. As you are already aware, due to the nature of her service, people are understandably initially reserved about beginning therapy. Your testimonial may help allay some reservations enough to encourage them to begin their personal journey as you have done so yourself.
Pollin understands that you value your privacy, especially those of you in prominent positions. We want to assure you that your confidentiality is fully respected. However, for administration purposes, it would be appreciated if you can please include your name and contact details so that Pollin can contact you if she wishes to clarify any details with you.
Any references to your feedback will only refer to you as your preferred reference name. Please enter that below. It can be just your first name, your initials or your full name (if you are comfortable with that).