Client Survey - School Services Rev 2017 Question Title * 1. Communication: Yes No N/A I was contacted by the therapist at the beginning of my child's services. I was contacted by the therapist at the beginning of my child's services. Yes I was contacted by the therapist at the beginning of my child's services. No I was contacted by the therapist at the beginning of my child's services. N/A The therapist provided me with their contact information The therapist provided me with their contact information Yes The therapist provided me with their contact information No The therapist provided me with their contact information N/A Question Title * 2. Client Centered: Yes No N/A The therapist contacted me after my child's assessment and involved me in developing the plan to address my child's needs. The therapist contacted me after my child's assessment and involved me in developing the plan to address my child's needs. Yes The therapist contacted me after my child's assessment and involved me in developing the plan to address my child's needs. No The therapist contacted me after my child's assessment and involved me in developing the plan to address my child's needs. N/A The report I received following my child's assessment was helpful and informative. The report I received following my child's assessment was helpful and informative. Yes The report I received following my child's assessment was helpful and informative. No The report I received following my child's assessment was helpful and informative. N/A The therapist contacted me when my child was being discharged. The therapist contacted me when my child was being discharged. Yes The therapist contacted me when my child was being discharged. No The therapist contacted me when my child was being discharged. N/A Question Title * 3. Quality: Select the appropriate rating which best describes how you feel about the following statements: Strongly Agree Somewhat Agree Neither Disagree or Agree Somewhat Disagree Strongly Disagree I feel the services my child received were helpful. I feel the services my child received were helpful. Strongly Agree I feel the services my child received were helpful. Somewhat Agree I feel the services my child received were helpful. Neither Disagree or Agree I feel the services my child received were helpful. Somewhat Disagree I feel the services my child received were helpful. Strongly Disagree I was happy with the quality of services provided by the therapist. I was happy with the quality of services provided by the therapist. Strongly Agree I was happy with the quality of services provided by the therapist. Somewhat Agree I was happy with the quality of services provided by the therapist. Neither Disagree or Agree I was happy with the quality of services provided by the therapist. Somewhat Disagree I was happy with the quality of services provided by the therapist. Strongly Disagree Question Title * 4. Building Trust and Relationships: Select the appropriate rating which best describes how you feel about the following statements Strongly Agree Somewhat Agree Neither Disagree or Agree Somewhat Disagree Strongly Disagree I felt informed that I could consent to, or decline, services. I felt informed that I could consent to, or decline, services. Strongly Agree I felt informed that I could consent to, or decline, services. Somewhat Agree I felt informed that I could consent to, or decline, services. Neither Disagree or Agree I felt informed that I could consent to, or decline, services. Somewhat Disagree I felt informed that I could consent to, or decline, services. Strongly Disagree If I had questions about my child's services, I felt comfortable contacting the therapist. If I had questions about my child's services, I felt comfortable contacting the therapist. Strongly Agree If I had questions about my child's services, I felt comfortable contacting the therapist. Somewhat Agree If I had questions about my child's services, I felt comfortable contacting the therapist. Neither Disagree or Agree If I had questions about my child's services, I felt comfortable contacting the therapist. Somewhat Disagree If I had questions about my child's services, I felt comfortable contacting the therapist. Strongly Disagree If I contacted the therapist, they returned my call in a timely manner. If I contacted the therapist, they returned my call in a timely manner. Strongly Agree If I contacted the therapist, they returned my call in a timely manner. Somewhat Agree If I contacted the therapist, they returned my call in a timely manner. Neither Disagree or Agree If I contacted the therapist, they returned my call in a timely manner. Somewhat Disagree If I contacted the therapist, they returned my call in a timely manner. Strongly Disagree Question Title * 5. How likely is it that you would recommend Community Advantage Rehabiliation to a friend or colleague? Not at all likely Extremely likely 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title * 6. Discipline - The services received were for: Occupational Therapy Physiotherapy If you recall the name of your child's therapist, please enter below: Question Title * 7. What is the name of your child's school? Question Title * 8. If you wish to provide your name, please enter below: Question Title * 9. If you have general comments, please provide them below: Done