Customer Feedback Form

Thank you for taking the time to complete this form. We appreciate all feedback and endeavour to improve our services based on the information you provide.

If you have any questions or require assistance to complete this form, please don’t hesitate to get in contact on either 0430 645 086 or contact@calmandconnected.com.au

Thank you for the time you have taken to complete this form. It will be forwarded to our Director, Kate Keisler, who will respond within 5 business days.

Name
First Last
Contact details:
Date
MM slash DD slash YYYY
Please select:*
For your entry please select the applicable:*
- Relates to interactions with a client
- Relates to a services provided/available
- Relates to a therapist
- Other
Please tell us what you are happy or dissatisfied about and when it happened. If possible please provide us with the names of the people involved or any other specific details.*
What steps have you taken to resolve the matter?
What outcomes or next steps are you seeking?
Please upload any relevant documents
Max. file size: 128 MB.

Customer Feedback Form

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