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APPENDIX 3

Evaluation of the Complementary Therapy Service
We would be grateful if you could complete this form to give us some
feedback about the Complementary Therapy project.

Name

What complementary therapy treatment(s) did you receive? Please tick √
Aromatherapy Massage Aromatherapy Oil Blend

Reiki Indian Head Massage
Auricular Acupuncture Auricular Acupuncture Magnets
How did you find the treatment?
Please circle a score between 1 – 5 (Not very effective - Very effective)

Relaxing 1 2 3 4 5
Uplifting 1 2 3 4 5

Stress Relieving 1 2 3 4 5
Calming 1 2 3 4 5

Were you given enough information to support you to choose your treat-
ment? Please circle
1 2 3 4 5

Did you feel you were able to discuss the effects of your treatment each
week? YES/NO
Was the appointment time suitable for you?

1 2 3 4 5
Was the location suitable for you?

1 2 3 4 5
Is there anything else you would like to say about the service?

Thank you for taking the time to fill this out