Client Satisfaction Survey

Congratulations on completing our premarital program! To receive your certificate, please complete this form. Once completed, we will email you your certificate to you.

Name*
First Last
We will only used the information you provide for training purposes. Please indicate if you would prefer to remain "anonymous".
Email
Date
MM slash DD slash YYYY
Your Therapist's Name:*
How many sessions did you attend (estimate)?*
Which option BEST describes your experience at HRT?*
Please note that this is about the QUALITY of the services you received by your therapist, regardless of the outcome of your therapy sessions.
Please tell us why you chose the option above:*
Would you recommend HRT to others?*
Your Testimonial (optional but greatly appreciated):
Much like you, most potential clients appreciate hearing about others' experiences at HRT. Please share a brief (or long) testimonial about your experience and we may share it on our website without your full names attached. Thanks in advance.
Permission to publish your Testimonial:*
Captcha
Phone
This field is for validation purposes and should be left unchanged.