EXIT

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* 1. How long has your child received services at Special Kids?

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* 2. Have you previously, or do you currently, receive therapy services from another therapy center?

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* 3. If you receive services from another therapy center please share with us where.

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* 4. Why do you choose to bring your child to Special Kids?

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* 5. Would you recommend Special Kids to another family looking for therapy or nursing services?

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* 6. Do you agree with the following statements?

  Strongly Disagree Disagree N/A Agree Strongly Agree
My child's quality of life has improved since beginning care at Special Kids.
I am satisfied with the overall quality of care at Special Kids.
I believe the staff are fulfilling Special Kids' mission of serving Jesus Christ by caring for His children.
Special Kids' Family Resources has helped me become a better advocate for my child.
Special Kids' Family Resources has helped me learn about other resources in the community to help my child.

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* 7. Does your child receive speech therapy services from Special Kids?

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* 8. If your child receives speech therapy services, do you agree with the following statements?

  Strongly Disagree Disagree N/A Agree Strongly Agree
My child's communication ability has improved.
My child is more independent with his/her communication skills.
My child's peer/family relationships have improved.
My therapist provides helpful information that has improved my understanding of my child's diagnosis.
My therapist provides helpful ways to care for my child and improve communication skills at home.

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* 9. Does your child receive physical therapy services from Special Kids?

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* 10. If your child receives physical therapy services, do you agree with the following statements?

  Strongly Disagree Disagree N/A Agree Strongly Agree
My child's movement, strength, balance , and mobility have improved.
My child is more independent with his/her mobility.
My therapist provides helpful info that has improved my understanding of my child's diagnosis.
My therapist provides helpful ways to care for my child and improve mobility skills at home.

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* 11. Does your child receive occupational therapy services from Special Kids?

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* 12. If your child receives occupational therapy services, do you agree with the following statements?

  Strongly Disagree Disagree N/A Agree Strongly Agree
My child's fine motor and basic life skills have improved.
My child is more independent with daily life skills.
My therapist provides helpful information that has improved my understanding of my child's diagnosis.
My therapist provides helpful ways to care for my child and to improve quality of life for my child at home.

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* 13. Does your child receive feeding therapy services from Special Kids?

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* 14. If your child receives feeding therapy services, do you agree with the following statements?

  Strongly Disagree Disagree N/A Agree Strongly Agree
My child's feeding skills have improved (chewing, swallowing, etc.).
My child eats a greater variety of foods weekly.
My therapist provides helpful information that has improved my understanding of my child's diagnosis.
My therapist provides helpful ways to care for my child and improve feeding skills at home.

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* 15. Does your child receive nursing services from Special Kids?

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* 16. If your child receives nursing services, do you agree with the following statements?

  Strongly Disagree Disagree N/A Agree Strongly Agree
My child receives care in a safe, loving environment.
I am confident in the training and ability of the staff to care for my child.
My child receives adequate nutrition and food services.
My child benefits from the recreational therapy offered throughout the day.
My nurses provide helpful information that has improved my understanding of my child's diagnosis.
My nurses provide helpful ways to care for my child and to improve quality of life for my child at home.

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* 17. Does your child receive EQUIP services from Special Kids?

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* 18. If your child is a part of EQUIP, do you agree with the following statements?

  Strongly Disagree Disagree N/A Agree Strongly Agree
My child receives services in a safe, loving environment.
I am confident in the training and ability of the staff to care for my child.
My child's emotional and physical needs are being met.
My child has seen social and developmental progress.
The EQUIP specialists provide helpful ways to carry over what my child is learning at home.

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* 19. What has Special Kids meant to your family?

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* 20. Why would you recommend Special Kids to another family?

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* 21. Please share how Special Kids can serve your child and family better.

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* 22. What other services would you like to see Special Kids offer in the future?

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* 23. Do our facilities meet your child's needs?

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* 24. Are you aware Special Kids has a blog?

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* 25. Are you interested in learning more about our Nursing or EQUIP (peer-modeling) programs?

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* 26. Are you interested in your child being a "feature child" for Special Kids marketing opportunities?

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* 27. Are you interested in being contacted to be a part of a Special Kids event committee?

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* 28. If you would answered "Yes" to any of the above questions about being contacted for additional information on any of our services or programs, please share your contact information below.

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* 29. If you would like to receive a FREE Special Kids t-shirt for your child as a thank you for participating in this survey, please see the front desk for your t-shirt order form. You will also have the opportunity to purchase additional t-shirts for your family at that time for $10 each.

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