Our Mission ... to maximize children's abilities through delivering the highest quality of treatment and increasing parent/caregiver education. How are we doing? The staff of Aspire Pediatric Therapy & Rehab strives to provide quality care to our clients and their families. In our effort to do so, we feel it is very important to have feedback from our clients on a regular basis. We would appreciate it if you would take the time to fill out the following questionnaire. Thank you.     Strongly Disagree   No Opinion   Strongly Agree 1. The office staff was helpful and courteous. 2. I was able to schedule an appointment in a timely manner. 3. My child's appointment started and ended on time. 4. My child's therapist(s) was/were helpful and courteous. 5. The therapist(s) discussed the evaluation, treatment plan, and goals with me on a regular basis. 6. The therapist(s) provide me with a home program. 7. Overall, my experience at Aspire was a positive one. 8. I would recommend Aspire to my friends and family. 9. Which therapy services did you receive? (check all that apply) Physical Therapy Occupational Therapy Speech Therapy Additional Comments or Suggestions: Optional Information Your Name: Patient's Name: Your Therapist(s) name(s): Date(s) treatment was received: 4840 West Panther Creek, Suite 206 • The Woodlands, TX 77381 • P: (281) 681-3020 • F: (281) 298-9905