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Client-Hypnotherapist Feedback
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1.
Question 1.
About the Working Relationship With Your Hypnotherapist
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist listened to me effectively.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist understood things from my point of view.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist focused on what was important to me.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist accepted what I said without judging me.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist showed warmth toward me.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist fostered a safe and trusting environment.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist followed my lead during our sessions whenever thatwas appropriate.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist provided leadership during our sessions when/if thatwas appropriate.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
My hypnotherapist challenged me when/if that was appropriate.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
2.
Question 2.
About the Results of Working With Your Hypnotherapist
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
The sessions with my hypnotherapist helped me with whatever originally led me to seek hypnotherapy.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
Any changes which might have occurred in me as a result of my hypnotherapy have been positive and welcome.
Strongly Agree
Somewhat Agree
No Strong Feelings
Somewhat Disagree
Strongly Disagree
3.
Question 3.
Overall Satisfaction
Very Satisfied
Somewhat Satisfied
No Strong Feeling
Somewhat Dissatisfied
Strongly Dissatisfied
My overall level of satisfaction with the service provided by my hypnotherapist is:
Very Satisfied
Somewhat Satisfied
No Strong Feeling
Somewhat Dissatisfied
Strongly Dissatisfied