Client Feedback Form

    Please take a minute to give feedback on the service NSM has provided to you. This questionnaire is designed to continually raise the level of service given to our clients and your comments will be used to enhance the experience of others.

    This is a confidential document. However, non-identifying information may be used for the purposes of teaching, research, evaluation and conveying the value of NSM’s services.

    1. How did you hear about NSM?

    On a scale of 1-10 (1 being poor, 10 being excellent), how would you rate:

    2. The space/location where you met:

    3. The mediator/coach/facilitator’s preparation coming into the meetings:

    4. Your opportunity to have your needs heard in the meetings:

    5. The mediator/coach/facilitator’s ability to remain neutral:

    6. The mediator/coach/facilitator’s ability to establish a respectful relationship with the participants:

    7. The mediator/coach/facilitator’s ability to effectively work through the content that needed to be discussed (All parties were aware of the issues and were able to discuss them):

    In a couple of sentences, please state your overall evaluation of your experience with the service:

    Your name (optional):

    Your email (optional):

    Your phone no. (optional):

    Thank you for taking the time to give us your feedback!