Outpatient at Home Therapy Patient Experience Survey
1.
Name
2.
Phone Number
3.
Email Address
4.
What made you choose this program as opposed to going to a clinic for outpatient therapy?
5.
If needed, are you likely to use us again or refer a friend or family member? Why or why not?
6.
On a scale from 0-10 (0=very dissatisfied, 10=very satisfied), how satisfied were you with the experience?
7.
Do you have any suggestions for improving the program?
8.
Any additional comments or specific praise you’d like to give your therapist(s)?