Family Survey
Please let us know how we are doing. Mark the rating for each question that best indicates how well we have done during your time with us. If you or your child has received more than one therapy, please complete a separate survey for each discipline. Thank you!
1) What therapy did you/your child receive with us?
Occupational Therapy
Physical Therapy
Mental Health Services
Other, please specify
2) Did you/your child make progress during the therapy program with our clinic?
Excellent
Very Good
Good
Fair
Poor
3) Did the treating therapist/practitioner adequately explain the nature of the therapy they were providing?
Excellent
Very Good
Good
Fair
Poor
4) Did the treating therapist/practitioner explain how to implement home program activities for carryover outside of treatment sessions?
Excellent
Very Good
Good
Fair
Poor
Not Applicable
5) Were the assessments and reports you received clear, complete and easy to understand?
Excellent
Very Good
Good
Fair
Poor
Not Applicable
6) Were we available, courteous and able to help when you called on the phone?
Excellent
Very Good
Good
Fair
Poor
7) Was it easy to schedule your appointments?
Excellent
Very Good
Good
Fair
Poor
8) Were you/your child seen promptly and on-time?
Excellent
Very Good
Good
Fair
Poor
9) Did you find the treatment areas to be generally clean and comfortable?
Excellent
Very Good
Good
Fair
Poor
10) Were we able to help solve billing, insurance and other finance issues?
Excellent
Very Good
Good
Fair
Poor
11) What clinic location(s) were you/your child seen at? Oregon City NE Portland Hillsboro McMinnville Wilsonville
12) What was your overall level of satisfaction with our clinic?
Excellent
Very Good
Good
Fair
Poor
13) Would you recommend us to your friends and family?
Yes
No
14) If you would, please tell us a little about how you feel therapy has benefited or been most helpful for your child and family. If you would also like to thank a particular staff member, please share below.
15) Are there any suggestions or areas of concern you would like to address?
Please provide your email