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Welcome home :)

Welcome home :)

Progress Sheet

Are we helping you feel better?

Name *

First Name

Last Name

Session Date *

MM

DD

YYYY

What issue did you work on today with us?

Progress

My main issue has gotten easier to deal with since my 1st visit.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I have been able to handle my own life better since my 1st visit.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I have noticed moments where I feel more peace and control over my life.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I have gotten closer to my goals since my 1st visit.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I have a more positive outlook on life since my 1st visit.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Other comments

Thank you!

Liberty Healing Center

libertyhc@gmail.com
(480) 868-8001

2405 E Southern Ave
Tempe, AZ 85282

H.E.M.S.
Hypnotherapy
Reiki Energy Healing
Dating & Intimacy Coaching