Spiritual Services — Feedback Date: * MM DD YYYY Name of Reader: * First Name Last Name Client's Name: * First Name Last Name Phone: * (###) ### #### Email: * Was this your first reading? * Yes No May we add you to our mailing list? * Yes No Would you be interested in hosting a reading or Meditation and Messages event? * Yes No Likelihood you would recommend to others? * Very Likely Not Sure Would Not Recommend May any of your comments and experiences be added to our website or promotional materials? * Yes No Client Agreement * Intuitive readings are suited for adults at least 18 years of age and are for entertainment purposes only. The information shared is subject to your own interpretation and you understand that any information/guidance provided does not constitute or substitute for legal, psychological, financial, medical, or business advice. Agree Your honest responses to the following are appreciated and will be used to improve the services offered. * Was there spirit contact? Yes No * Was there specific evidence provided that enabled you to recognize the person? Yes No * Did the message offered provide relevance and healing? Please explain: * What part of this experience was most significant for you? * This experience was: (Please check all that apply) Insightful Helpful regarding current issues Provided closure Created connection Helpful regarding past issues Provided comfort Provided insight and possibilities I hadn’t thought of Additional comments: Thank you!
