{"id":2581,"date":"2025-06-08T23:48:04","date_gmt":"2025-06-08T13:48:04","guid":{"rendered":"https:\/\/backontrackpsych.com\/?page_id=2581"},"modified":"2025-06-08T23:48:04","modified_gmt":"2025-06-08T13:48:04","slug":"feedback-form","status":"publish","type":"page","link":"https:\/\/backontrackpsych.com\/zh\/feedback-form\/","title":{"rendered":"\u610f\u89c1\u53cd\u9988\u8868"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div class=\"\"><div class=\"container\"><div class=\"vc_row wpb_row vc_row-fluid\" ><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div class=\"gt3_spacing\"><div class=\"gt3_spacing-height gt3_spacing-height_default\" style=\"height:28px;\"><\/div><\/div>  \n<div data-color=\"#ffffff\" class=\"gt3_custom_text\" style=\"color:#42474c;font-family:Raleway;font-weight:300;font-style:normal;font-size: 45px; line-height: 165%; \">We want your opinion.<\/p>\n<\/div><div class=\"gt3_spacing\"><div class=\"gt3_spacing-height gt3_spacing-height_default\" style=\"height:12px;\"><\/div><\/div>  \n<div class=\"vc_separator wpb_content_element vc_separator_align_center vc_sep_width_100 vc_sep_pos_align_left vc_separator_no_text wpb_content_element  wpb_content_element wpb_animate_when_almost_visible wpb_fadeInLeft fadeInLeft wpb_animate_when_almost_visible wpb_fadeInLeft fadeInLeft\" ><span class=\"vc_sep_holder vc_sep_holder_l\"><span style=\"border-color:#EC3C81;\" class=\"vc_sep_line\"><\/span><\/span><span class=\"vc_sep_holder vc_sep_holder_r\"><span style=\"border-color:#EC3C81;\" class=\"vc_sep_line\"><\/span><\/span>\n<\/div><div class=\"gt3_spacing\"><div class=\"gt3_spacing-height gt3_spacing-height_default\" style=\"height:25px;\"><\/div><\/div>  \n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f2572-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"2572\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/zh\/wp-json\/wp\/v2\/pages\/2581#wpcf7-f2572-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/zh\/wp-json\/wp\/v2\/pages\/2581#wpcf7-f2572-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2572\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2572-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"vc_row wpb_row vc_row-fluid\">\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<h4>Thank you for taking the time to provide feedback. Your insight helps us learn and improve.If you&#39;re feeling unsure, please know you&#39;re welcome to share as much or as little as feels comfortable for you.\n\t\t\t<\/h4>\n\t\t\t<p>&nbsp;\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<h4>Please rate the following statements:\n\t\t\t<\/h4>\n\t\t\t<p>(1 = Strongly Disagree | 5 = Strongly Agree)\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>1. I felt respected, listened to, and safe during my sessions.<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-367\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-367\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-367\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-367\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-367\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-367\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>2. My therapist supported me in working towards goals that mattered to me.<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-82\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-82\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-82\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-82\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-82\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-82\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>3. I gained useful tools or insights to manage challenges in my life.<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-614\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-614\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-614\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-614\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-614\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-614\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>4. I feel more equipped to make positive changes moving forward.<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-400\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-400\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-400\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-400\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-400\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-400\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>5. Overall, I am satisfied with the support I received.<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-112\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-112\" value=\"1\" \/><span class=\"wpcf7-list-item-label\">1<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-112\" value=\"2\" \/><span class=\"wpcf7-list-item-label\">2<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-112\" value=\"3\" \/><span class=\"wpcf7-list-item-label\">3<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-112\" value=\"4\" \/><span class=\"wpcf7-list-item-label\">4<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-112\" value=\"5\" \/><span class=\"wpcf7-list-item-label\">5<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p>&nbsp;\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<h4>Open Feedback\n\t\t\t<\/h4>\n\t\t\t<p>&nbsp;\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>What did you find most helpful in your sessions?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-203\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Optional: Share what made a difference for you.\" name=\"textarea-203\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>What could have been better or felt different?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-421\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"If something was hard or unhelpful, we\u2019d appreciate knowing how we could improve.\" name=\"textarea-421\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>Is there anything else you\u2019d like us to know?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-877\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Your ideas or suggestions are welcome.\" name=\"textarea-877\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p>&nbsp;\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<h4>Final Questions\n\t\t\t<\/h4>\n\t\t\t<p>&nbsp;\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>Would you recommend Back on Track Psychology to someone else?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-616\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-616\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-616\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-616\" value=\"Not sure\" \/><span class=\"wpcf7-list-item-label\">Not sure<\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><label>If you would like a response to your feedback, please leave your name and contact details:<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-778\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"This is optional. Your feedback can remain anonymous.\" name=\"textarea-778\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n\t\t<div class=\"vc_column-inner\">\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-716\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-716\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I have read and agree to the <a href = \"https:\/\/backontrackpsych.com\/zh\/privacy-policy\/\">Privacy Policy and Terms of Service<\/a><\/span><\/label><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"11\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"zh\"\/><\/form>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"\"><div class=\"container\"><div class=\"vc_row wpb_row vc_row-fluid\" ><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div class=\"gt3_spacing\"><div class=\"gt3_spacing-height gt3_spacing-height_default\" style=\"height:70px;\"><\/div><\/div>  \n<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"\"><div class=\"container\"><div class=\"vc_row wpb_row vc_row-fluid\" ><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"We want your opinion. Thank you for taking the time to provide feedback. Your insight helps us learn and improve.If you&#39;re feeling unsure, please know you&#39;re welcome to share as much or as little as feels comfortable for you. &nbsp; Please rate the following statements: (1 = Strongly Disagree | 5 = Strongly Agree) 1. [...]","protected":false},"author":255179603,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_wpcom_ai_launchpad_about_page":false,"_wpcom_ai_launchpad_gallery_page":false,"footnotes":""},"class_list":["post-2581","page","type-page","status-publish","hentry"],"jetpack_likes_enabled":true,"jetpack-related-posts":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/PgxwEY-FD","_links":{"self":[{"href":"https:\/\/backontrackpsych.com\/zh\/wp-json\/wp\/v2\/pages\/2581","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/backontrackpsych.com\/zh\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/backontrackpsych.com\/zh\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/backontrackpsych.com\/zh\/wp-json\/wp\/v2\/users\/255179603"}],"replies":[{"embeddable":true,"href":"https:\/\/backontrackpsych.com\/zh\/wp-json\/wp\/v2\/comments?post=2581"}],"version-history":[{"count":4,"href":"https:\/\/backontrackpsych.com\/zh\/wp-json\/wp\/v2\/pages\/2581\/revisions"}],"predecessor-version":[{"id":2585,"href":"https:\/\/backontrackpsych.com\/zh\/wp-json\/wp\/v2\/pages\/2581\/revisions\/2585"}],"wp:attachment":[{"href":"https:\/\/backontrackpsych.com\/zh\/wp-json\/wp\/v2\/media?parent=2581"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}