HOW ARE WE DOING?

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* 1. Client Name (Optional):

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* 2. Therapy Service (PT, OT, SLP): 

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* 3. Therapist (s): 

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* 4. Relationship to patient (Self, Parent, etc.):

This survey is indented to help identify ways MECA Therapies can improve as a company, and as a way to assess how satisfied you were with the services that were provided to you and your child. Your feedback is very important to us and is crucial to our future success, so please be as honest as possible in your responses. Also know that all gathered information is for internal purposes only and will not be disclosed or discussed with outside sources.
Referral and Accessibility to Program

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* 5. Please rate the effectiveness of our front office staff (check all that apply)

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* 6. How did you hear about MECA Therapies Children's Outpatient Clinic?

Evaluation

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* 7. My child received a comprehensive evaluation that addressed your concerns

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* 8. I received a written copy of the evaluation results that was easy to understand

Treatment

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* 9. My therapist included me in developing my child's treatment plan

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* 10. My child's therapist(s) thoroughly explains my child's treatment activities and progress after each session 

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* 11. My child's therapist answers my questions and concerns

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* 12. My child's treatment sessions begin promptly when I arrive

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* 13. My therapist is kind to my child

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* 14. My therapist gives my child therapy activities to do at home

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* 15. My child's therapist provides me with information when I have questions or concerns

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* 16. My rights have been respected as a parent 

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* 17. My therapist is competent when working with my child

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* 18. The office is clean and sanitized

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* 19. How would you rank your overall impression of MECA Therapies?

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* 20. What could we have done to make your visit better?

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* 21. What did you like the most about MECA Therapies?

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* 22. What did you like the least about MECA Therapies?

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* 23. If any individual gave you outstanding attention, please let us know so we can commend that person. Also, if you would like to share some constructive criticism, let us know, and we will seek appropriate solutions.

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