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)?