Feedback form for the client during and after therapy

This form is completely confidential, and no information will be passed to the authorities, or third parties. Statistical information will be collated and used to access fundraising to subsidise therapy.

Please enter the ID we sent you when you signed up


Not at all











Completely



Not bothered at all











Very distressed



Not bothered at all











Very distressed



Not at all useful











Extremely useful

















This will help us make our site more accessible to other people