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Therapeutic Riding Participant Evaluation

Name
MM slash DD slash YYYY
MM slash DD slash YYYY

Thank you for being part of the Quantum Leap Farm family. We would appreciate it if you would take a few minutes to tell us about your experience at the Farm so far. Please circle the response that best describes your feelings. Thank you for your feedback & help!

1) Riding at Quantum Leap Farm has helped me improve my physical well-being.
2) Riding at Quantum Leap Farm has helped me improve my self-confidence.
3) Riding at Quantum Leap Farm has helped me improve my postural control.
4) Riding at Quantum Leap Farm has helped me improve my balance.
5) Riding at Quantum Leap Farm has helped me improve my flexibility.
6) I believe that riding or participating in services at Quantum Leap Farm has improved my quality of life.
7) I believe that when I rider or participate in services at Quantum Leap Farm I am safe.
8) I am very satisfied by the services I receive at Quantum Leap Farm.
9) I believe that participating in services at Quantum Leap Farm has had a positive impact on my daily living.

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