Feedback Form | Raewyn Fernandez

Client Feedback Form - External Basti Therapy

Date of Treatment

Therapists Name

Client’s Name

Client’s Age

Previous experience with Ayurveda or Basti Therapy:

Please answer yes/no where applicable, and elaborate in the space provided.

Did you feel clearly informed and prepared before the treatment began?

Were you comfortable with the practitioner’s presence, touch, and communication style?

Was the temperature of the oil comfortable throughout the session?

Did the oil feel well-contained and secure during the treatment?

How was the treatment room environment (temperature, music, lighting, cleanliness, overall feel)?

How did you feel during the Basti e.g. Deeply relaxed, sleepy, transcendent, emotionally moved, agitated)?

Did you feel supported during the resting period after the Basti was removed?

How would you describe your state or any sensations after the treatment?

Did you notice any changes or improvements across the days of the treatment? If so, what were they?

What did you appreciate most about the treatment experience?

Was there anything that could have been improved or done differently to enhance your experience?

Would you consider receiving another Basti treatment in the future?

Any reflections, insights or feedback you’d like to share?

Thank you so much for yiur feedback