Needs Analysis

Holistic Support Therapy

We're a start up organization looking to provide therapeutic interventions, educational and behavioral support to children with learning difficulties, both in home and in the school setting. This survey aims to gain information regarding the needs in your area and if such an organization will be an advantage to you and your community.

Question Title

* 1. Are you a parent or teacher of a child with behavioral or learning difficulties?

Yes

Question Title

* 2. Does your child or student need additional educational support?

Yes

Question Title

* 3. Does your child or student need behavioral support?

Yes

Question Title

* 4. Tick the areas in which your child or student needs behavioral support:

Social Skills

Speech and Communication

Attention

Self-control

Compliance

Independence

Repetitive Behavior

Flexibility

Sensory

Other (please specify)

Question Title

* 5. Tick the areas in which your child or student needs academic support:

Perseverance

Problem Solving

Mathematics

Language

Other (please specify)

Question Title

* 6. Has your child or student been diagnosed with any learning or developmental disorder?

Yes

Other (please specify)

Question Title

* 7. Would you like your child or student to be a part of a holistic therapeutic approach supporting you and your child or student in challenging areas?

Yes

Other (please specify)

Question Title

* 8. Would you as a parent or teacher like training and support?

Yes

Other (please specify)

Question Title

* 9. Do you feel as a parent or teacher that an organization assisting with your child or student's needs is easily accessible?

Yes

Other (please specify)

Question Title

* 10. If you would like us to contact you regarding our organization, please leave your preferred contact details below:

Name

City/Town

Email Address

Phone Number