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  5. Feedback Survey
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Exit Survey
 
 
I was treated professionally and with respect by my therapist
 
1 (Rarely)
 
2 (Sometimes)
 
3 (Often)
 
4 (Always)
 
 
 
I received a complete explanation of my treatment goals
 
1 (Not true)
 
2 (Sometimes true)
 
3 (Often true)
 
4 (Very true)
 
 
 
Activities were designed to be appropriate to my level
 
1 (Not true)
 
2 (Sometimes true)
 
3 (Often true)
 
4 (Very true)
 
 
 
My questions were answered
 
1 (Not true)
 
2 (Sometimes true)
 
3 (Often true)
 
4 (Very true)
 
 
 
I received a complete explanation of my home excercise program
 
1 (Not true)
 
2 (Sometimes true)
 
3 (Often true)
 
4 (Very true)
 
 
 
I am practicing as directed by my therapist
 
1 (Not true)
 
2 (Sometimes true)
 
3 (Often true)
 
4 (Very true)
 
 
 
I am noticing development in my goal areas.
 
1 (Not true)
 
2 (Sometimes true)
 
3 (Often true)
 
4 (Very true)