Name:
Email address:
Did you understand the process involved in the EFT session?
Yes/No:
Please give your suggestions for improvement:
Would you be willing to give a testimonial for use on my web site or other promotional material?
Yes/No:
No personal details will be used unless you permit them to be.
Would you be happy to refer family or friends to me?
Yes/No:
If not please tell me why?
Would you be interested in?
Workshops on ‘Building Successful Relationships’ Yes/No
Workshops on ‘Attracting The Right Partner & Keeping Them’ Yes/No
Workshops on ‘Creating The Life You Were Made For’ Yes/No
Receiving my monthly email newsletter? Yes/No
Receiving news on workshops and events? Yes/No
May I use your comments on promotion or advertising literature? Yes/No
Other commments or feedback on the session/s: