Mediation Feedback Form – Oakhill Counselling & Mediation Services

Name

First

Last

Address/City/PC

Phone Number

Email

How did you hear about Oakhill? *

Did you use Oakhill Counselling and Mediation for your mediation process?

Yes
No

If Yes, what did you appreciate about the service provided?

Is there anything we could do different to make this a more positive experience?

If NO, can you tell us a bit about why you didn't use our service?

Can you give us some specific details about why you chose not to use Oakhill's mediation service? (responses are confidential and only reviewed by the clinical supervisor)

What criteria were you looking for to choose a mediator?

Would you recommend Oakhill Counselling for Mediation services to those you know?

Yes
No
Not sure

Would you like us to follow up with you? *

Yes
No

If you would like us to follow up, please make sure you have left an email address or phone number above. Thank you for your feedback. It is greatly appreciated!