Private therapy feedback form

What service did you and your child receive from us?

Initial consultation

Single / one off therapy session

Block of therapy sessions

Other

How was the therapy session delivered?

Face to face / in person

video / online

Combination of video and face to face

We are constantly looking to improve our virtual therapy services. Please tick any of the statements below that apply to you

I like that I do not have to travel

I like that you can see our home set up

Doing therapy virtually gave me the opportunity to practice therapy activities directly with my child

I could follow the instructions / demonstrations during the video sessions

It was difficult to manage other siblings during the video sessions

My child behaved better at home than in a clinic when doing specific therapy activities

My child behaved better in a clinic than at home when doing specific therapy activities

I was able to set up the technology required

I found it difficult to manage the technology during the video sessions

I found the video call invasive to our privacy

I find video sessions easier than face to face sessions

I find face to face sessions easier than video sessions

I would recommend virtual therapy to other families / service users

I would not recommend virtual therapy to other families / service users

We are constantly looking to improve our virtual therapy services. Please tick any of the statements below that apply to you

I like that I do not have to travel

I like that you can see our home set up

Doing therapy virtually gave me the opportunity to practice therapy activities directly with my child

I could follow the instructions / demonstrations during the video sessions

It was difficult to manage other siblings during the video sessions

My child behaved better at home than in a clinic when doing specific therapy activities

My child behaved better in a clinic than at home when doing specific therapy activities

I was able to set up the technology required

I found it difficult to manage the technology during the video sessions

I found the video call invasive to our privacy

I find video sessions easier than face to face sessions

I find face to face sessions easier than video sessions

I would recommend virtual therapy to other families / service users

I would not recommend virtual therapy to other families / service users

How satisfied were you with the therapy session(s) you received?

Very satisfied

Satisfied

Neutral

Unsatisfied

Very unsatisfied

Has the therapy session(s) contributed to your knowledge and understanding of your child's needs?

Yes

No

Unsure

Did you see a change in your child's abilities as a result of the therapy session(s)?

Much better

A little better

No change

Worse

Has the therapy and the advice you have received helped you address any concerns you may have had prior to the session?

Yes, completely addressed my concerns

Yes, to a large extent

Yes, partially

No, not at all

Please tell us how the sessions may have helped you and / or your child? You may tick more than one box

Provided an opportunity to discuss concerns regarding my child

Provided emotional support

Improved my confidence in supporting my child

Improved my child's confidence

Provided practical advice and strategies I can use at home

Enabled me to be more active in carrying our activities directly with my child

Other

Would you like to access more private therapy sessions in the future?

Yes

No

Unsure at this point

What service did you receive from us?

Initial consultation

Single / one off therapy session

Block of therapy sessions

Other

How was the therapy session delivered?

Face to face / in person

video / online

Combination of video and face to face

We are constantly looking to improve our virtual therapy services. Please tick any of the statements below that apply to you

I like that I do not have to travel

I like that you can see our home set up

Doing therapy virtually gave me the opportunity to practice therapy activities at home

I could follow the instructions / demonstrations during the video sessions

I was able to set up the technology required

I found it difficult to manage the technology during the video sessions

I found the video call invasive to my privacy

I find video sessions easier than face to face sessions

I find face to face sessions easier than video sessions

I would recommend virtual therapy to other families / service users

I would not recommend virtual therapy to other families / service users

We are constantly looking to improve our virtual therapy services. Please tick any of the statements below that apply to you

I like that I do not have to travel

I like that you can see our home set up

Doing therapy virtually gave me the opportunity to practice therapy activities at home

I could follow the instructions / demonstrations during the video sessions

I was able to set up the technology required

I found it difficult to manage the technology during the video sessions

I found the video call invasive to my privacy

I find video sessions easier than face to face sessions

I find face to face sessions easier than video sessions

I would recommend virtual therapy to other families / service users

I would not recommend virtual therapy to other families / service users

How satisfied were you with the therapy session(s) you received?

Very satisfied

Satisfied

Neutral

Unsatisfied

Very unsatisfied

Did you see a change in your abilities as a result of the therapy session(s)?

Much better

A little better

No change

Worse

Has the therapy and the advice you have received helped you address any concerns you may have had prior to the session?

Yes, completely addressed my concerns

Yes, to a large extent

Yes, partially

No, not at all

Please tell us how the sessions may have helped you. You may tick more than one box

Provided an opportunity to discuss concerns

Provided emotional support

Improved my self confidence

Provided practical advice and strategies I can use at home

Enabled me to be more active in carrying our activities

Other

Would you like to access more private therapy sessions in the future?

Yes

No

Unsure at this point