Submit Your Testimonial Here

Name*

Mr/Mrs/Ms First Last

Email*

Enter Email Confirm Email

Phone

We will only contact you by telephone if there is a query about this testimonial. This field is not required.

Name of Chi Practitioner*

Please select the Chi Practitioner(s) to whom this testimonial relates to.

Master Ha

Françoise Ha

Ruth Mitchell

Are you having Chi Treatments:*

In-person

Remote sessions via Skype/Telephone

How many treatments have you had so far?

What symptoms did you have before starting treatments?*

How did you feel mentally and emotionally before starting treatments?*

Have you tried other therapies for your symptoms and for how long?*

How do you feel now after your treatments: physically, mentally and emotionally?*

Have you noticed paths opening up for you since starting treatments?*

This may include changes in relationships and family, work and career and/or other developments.

How would you describe Chi Therapy to someone who has never had a treatment before?*

Would you recommend Chi Therapy to others?*

Strongly agree	Agree	Neutral	Disagree

Is there anything else you would like to mention about your Chi Practitioner?

What else would you like to say about your Chi session(s) experience?

Permission to Publish*

Please select the option you prefer

Yes, I am happy for you to publicly publish this testimonial using my real first name and the first letter of my surname

Yes, I am happy for you to publicly publish this testimonial either anonymously or using a pseudonym

Private Message

Please write any additional private notes to the Chi Practitioners at The Chi Zone here. They will not be published.

Signature*

Please sign this form using your mousepad or touchscreen

Hidden

Main Symptom(s)

Administrator to add this heading after reading testimonial.

Your Chi Experience