Activity Interest Survey
Grow Pediatric Therapy & Group Services, LLC is owned/operated by two pediatric occupational therapy practitioners and we would love to know how we can best serve you and your family. Please take a few minutes to complete our survey. Your responses are anonymous but there is an option at the end to leave your email address if you would like for us to contact you about any of these services or activities. Feel free to share this survey with anyone else who you think would be interested. Thank you for your time!
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Which of these activities would interest you?
Who would you consider enrolling?
How old is/are your child(ren)?
Does your child receive other services?
Clear selection
If we offered insurance-reimbursable, individual therapy services, what services would you be interested in?
Who is your insurance provider?
What days and times would work best? Check all that could apply. (Note: if using a mobile device, you will need to scroll horizontally to see all options)
Before school (7AM-8AM)
Morning (8AM-12PM)
Afternoon (12PM-3PM)
After school (3PM-5PM)
Evening (5PM-6PM)
Later than 6PM
None
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
How long would you prefer the activity/group to last?
Would you prefer individual or group activities?
Clear selection
How often would you enroll in these activities?
Clear selection
What is the maximum amount you would pay per activity/group?
Clear selection
What is the maximum amount you would pay per week?
Clear selection
What is the maximum amount you would pay per month?
Clear selection
Optional: Type your email address below if you'd like for us to contact you about our current offerings or future programs that match your responses.
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