Feedback Form

You can use this form to offer feedback confidentially to Jac. 

Feedback offers an opportunity for both the giver and receiver. When we offer feedback we influence and impact each other. This form offers you to an opportunity to give different kinds of feedback to Jac; you can inform her about any impact (helpful or otherwise) that she has had on you. As you prepare to give feedback we ask that you are mindful that the primary purpose of feedback is to encourage personal and professional growth through increased awareness of our impact on each other as human beings.

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Your name
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Check below if you wish to remain anonymous (please note: if you wish to remain anonymous Jac will be not be able to follow up with you).
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If you attended a recent event or retreat with me (Jac), how would you rate your overall experience?

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Are you open to me sharing your positive feedback as a public testimonial?

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