Client Feedback - Conflict Resolution Service

Relationship - Did you feel heard, understood and respected

Please rate from 1 -5 how well you felt heard, understood, or respected. 1 being not heard.

Goals and Topics - Did we work on or talk about what you wanted?

Approach - Did the Mediator's approach work for you?

1 = The approach was not a good fit. 5= It worked well for me

Mediator/CRS Staff - Did the Mediator / staff person guide the discussion or assist the process?

1 = the mediator/ staff did not. 5 = The mediator/staff helped guide the discussion and process.

Name of Mediator/s

Optional

Outcomes (if applicable) - Were the outcomes fair and workable?

Overall - Were you happy with your contact with CRS

1= not happy, 5 = very happy

What service did you receive?

Do you have any other feedback, positive or negative, about your experience at CRS?

Name

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Email

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Please provide your email address if you would like to receive a follow up to this feedback.

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Phone

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Feedback Form