CTA Electronic Workshop Survey

The intention of this survey is to get a sense of the long-term effects of our workshops. Please fill out a form for each workshop you attended. And, thank-you in advance for completing this survey.

Healing the Father Wound® Women Men
Healing the Mother Wound®
Women Men
Clearing the Air™ Between Women & Men

Buckhorn Retreat Center, Ashland, OR
Camp Augusta, Nevada City, CA
Cielo en Terra, Huachuca City, AZ
Coleman Studios, New York, NY

Harbin Hot Springs, Middletown, CA
Kopp Center, Lake Geneva, WI
The Lodge at Sleepy Creek, Berkeley Springs, WV
Lutz Ranch, Morgan Hill, CA
Motherroot Farm, Beloit WI
Phoenicia Pathwork Center, Phoenicia, NY
Westerbeke Ranch, Sonoma, CA

Please rate your agreement with the following statements: 
"After participating in the workshop...

Strongly Disagree
Strongly Agree

...it changed my relationship in a positive way with my (check all that apply)


...I am more accepting of them and how we interact.

...I am more forgiving of them

...I believe the relationship is healed.

...It had a positive impact on my life

...I am more in touch with my inherent feelings.

...I am more comfortable expressing my inherent feelings in the moment

...I have used Tantrum Yoga® since the workshop (comment)

...my relastionships with women are better

...my relatinships with men are better

...my relationship with my significant other is better

...my relationship with my kids are better (if a parent/step-parent)

...my relationships at work are better

...I am more involved with my community

...I am more involved with my spirituality

...I am more accepting of others

...I am more pleased with the kind of work I do in the world.

...I am more involved in my local community

...I am activly doing more to protect the environment

...I am more accepting of myself.

...more aware that my actions affect others

...convinced that I can make a difference

...more likely to work to improve relationships

...I understand other people's experiences

...I am taking better care of myself emotionally

...I am taking better care of myself physically

...I am genereally more excited about life.

Please elaborate fully here on any of the above:

Was there anything specifically that you remember about the workshop that was particularly powerful?

During the workshop, did you make a commitment for change? What commitment did you make and how is it going?

Were any of the skills taught in the workshop, such as time in nature, Tantrum Yoga ®, helpful in your personal life?

Any additional comments?

Please rate your workshop facilitator: Poor Average Good Very Good Outstanding
Please comment?

Please rate the workshop: Poor Average Good Very Good Outstanding Life altering
Please comment?

I give the workshop facilitator(s) permission to use any of my above comments in whole or in part.Yes, No.

May we contact you in the future for a follow-up survey? (This is completely optional and voluntary.) Yes, No.

Snail Mail (including zip code):

Home Phone
Cell phone
Birthdate MM/DD/YYYY

For questions contact us here

Anti-Spam * Type in this field * Required Field