Member Login
|
Contact Us
Tips & Tools
Programs
Events
Paradigm Shift
Matrixx Event
One Percent Club
Blog
About Us
Our Story
Success Stories
Giving Back
Your Feedback is Important to Us
Full Name
Email
Phone
Case Record Type
Survey
Case Reason
--None--
User didn't attend training
Complex functionality
Existing problem
Instructions not clear
New problem
Program Application
Status
--None--
On Hold
Escalated
Closed
New
Priority
--None--
Urgent
High
Medium
Low
Subject
Date of Birth (ex. 12/01/1988)
Sex/Gender
--None--
Male
Female
Marital Status
--None--
Single
Married
Divorced
Widowed
Domestic Partnership
Did you consider any alternatives to our program and the Proctor Gallagher Institute?
--None--
Yes
No
If so, which ones / how many?
What can you tell us about yourself?
What is your goal?
What are you wanting to achieve with this program?
How is your life better thanks to the program?
What made you sign-up for our program?
Which doubts and hesitations did you have before committing to the program?
What’s the one thing that nearly stopped you from working with us?
Which questions did you have, but couldn’t find answers to on the website?
What was your biggest challenge, frustration or problem in finding the right program?
Anything else you would like to tell us?
Thank you for your feedback!