Company Accountability Feedback Form

I am committed to creating training programs that serve the greatest possible good, which means that I am forever committed to learning. If you have any input that would up-level my services, teachings, and programs, I am grateful. I especially want to invite feedback that will help me better serve marginalized communities.

Please offer your thoughts, feelings, and ideas in the fields provided. Feel free to stay anonymous if you desire.

Name (optional)

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Feedback

What brought you to fill out this form?

How would you like it to be addressed?

Is personal repair/amends needed or desired?

Yes

If you would like to be contacted personally to follow up, please leave your email:

Do you have any desires or intentions for follow up that you would like to state?

Name

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