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Therapeutic Riding Caregiver/Case Manager Evaluation
Name of Participant
First
Last
Date
MM slash DD slash YYYY
Date of Birth of Participant
MM slash DD slash YYYY
Caregiver/Case Manager
First
Last
Thank you for supporting your rider/participant at Quantum Leap Farm. We would appreciate it if you would take a few minutes to tell us how the experience at the Farm has benefitted your rider/participant Please circle the response that best describes your feelings. Thank you for your help!
1) Riding at Quantum Leap Farm has helped my rider/participant improve his/her physical well-being.
Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
2) Riding at Quantum Leap Farm has helped my rider/participant improve his/her self-confidence.
Strongly Agree
Agree
Not Applicable
Disagree
Strongly Disagree
3) Riding at Quantum Leap Farm has helped my rider/participant improve his/her postural control.
Strongly Agree
Agree
Not Applicable
Disagree
Strongly Disagree
4) Riding at Quantum Leap Farm has helped my rider/participant improve his/her balance.
Strongly Agree
Agree
Not Applicable
Disagree
Strongly Disagree
5) Riding at Quantum Leap Farm has helped my rider/participant improve his/her flexibility.
Strongly Agree
Agree
Not Applicable
Disagree
Strongly Disagree
6) I believe that riding or participating in services at Quantum Leap Farm has improved the quality of life for my rider/participant.
Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
7) I believe that when my rider/participant receives services at Quantum he/she is safe.
Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
8) I am very satisfied by the services my rider/participant receives at Quantum Leap Farm.
Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
9) Please tell us about your experience at Quantum Leap Farm:
10) How can we improve our services:
Close Menu
Support
Donate Today
Ways to Give
Volunteer
Partners
Donate a Horse
Donate Crypto Currency through BitPay
About
Mission
Staff
Horses & Farm Residents
Board of Directors
Financials
Services
Benefits of Participation
Therapeutic Riding
Hippotherapy
Warrior Mission: At Ease Military Retreats
EASE (EAGALA EAP/EAL)
Corporate Workshops
Military Programs
Visits, Tours & Other Programs
Events
Horse Play | Nov 3, 2023
Family Fun Days 2023
Holiday Bash | Dec 16, 2023
Stirrup Hope 2023 – Post Event
Colors of Courage 2023 – Post Event
Contact