Client Service Experience General Information What service did you or your child receive at our clinic? Evaluation Direct Therapy Both How did you hear about our practice? If receiving direct therapy, how long have you or your child been receiving therapy/intervention at TPE? Quality of Care How satisfied are you with the overall quality of services (evaluations, speech, language or dyslexia therapy, OG Intervention)? Very satisfied Moderately satisfied Neither satisfied nor dissatisfied Moderately dissatisfied Very dissatisfied How would you rate the professionalism and expertise of the therapists and evaluators at TPE? Exceptional Good Fair Poor What do you like best about our practice? What areas could we improve? Progress & Outcomes of Therapy Describe the improvement in your child’s speech, communication, reading or writing related skills? Communication & Environment How would you rate the friendliness, helpfulness and communication of the scheduling staff? Exceptional Good Fair Poor How would you rate the friendliness, helpfulness and communication of the billing staff? Exceptional Good Fair Poor Testimonial Would you be willing to provide a testimonial that we can use for marketing purposes? Yes No If yes, please leave your contact information below: Thank you!
