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* 1. How did you learn about the athletic training services that we provide?

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* 2. Was this your first experience with a Certified Athletic Trainer (ATC)?

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* 3. Was this your first experience with this particular ATC?

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* 4. Please check the location of the injuries for which you/your child received treatment and/or therapy during this school year. (Check all that apply)

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* 5. Please rate your degree of satisfaction with each of the following statements.

  Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree
My privacy was respected during my treatment and care
My athletic trainer was courteous
I received treatment and therapy at convenient times
I was satisfied with the treatment and therapy provided
It was easy to schedule visits with the ATC after my first visit
I was seen promptly when I arrived for treatment
The location of the athletic training room was convenient for me
The athletic trainer understood my problems or conditions
The instructions the athletic trainer gave to me were helpful
I was satisfied with the overall quality if my treatment and care
I would recommend this service to other SCA families
I would return to this athletic training facility if I required care in the future
Overall, I was satisfied with my experience

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* 6. Please feel free to add any additional comments here:

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* 7. Athlete/Parent Information (Name, Age, Gender) *Optional

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