GLA:D™ Canada Patient Feedback Form

Thank you for participating in the GLA:D™ Canada Program. Your feedback is important in maintaining the integrity of this program.

Program Site*
City*
Therapist*
The GLA:D™ Canada program is coordinated nationally. Can this feedback be shared with the national team (including partners in various provinces)?
- Yes
- No
How would you rate your overall satisfaction with the program?*
Completely Dissatisfied Dissatisfied Neither Satisfied nor Dissatisfied Satisfied Completely Satisfied
Do you feel that your therapist was knowledgeable and able to answer your questions pertaining to osteoarthritis?*
No Knowledge Little Knowledge Unsure Some Knowledge Very Knowledgeable
Were you confident in your therapist’s skills when participating in the exercise sessions?*
Not Confident Little Confidence Unsure Some Confidence Very Confident
Was the therapist hands-on during the exercise sessions to adjust your body alignment when required?*
Not Hands-On A Little Hands-On Unsure Some Hands-On Very Hands-On
Were exercises modified and progressed to suit your individual skill level?*
- Yes
- No
Other Comments
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