Feedback Survey for HeartSpace Nervous System Resets

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Thank you for taking the time to fill out this survey. We'd love your feedback on what you've noticed about these last few weeks!

Please describe any changes or benefits you've noticed from participating in this experience.

Please describe any improvements we could implement.

How likely are you to participate in the future if offered?

Very unlikely

Very likely

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Any other comments or remarks?

You may choose to remain anonymous, but if you would like to include your name with these comments you may do so here:

We are occasionally asked to provide anecdotal data for our funding sources, presentations, etc. May we use your comments? (Any identifying information will not be included)

Yes

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This form was created inside of HeartSpace Clinic.