GI Alliance + GI Psychology Partnership Feedback Form

Partnership Feedback Form

We value your input and want to make this partnership as seamless and effective as possible. Please share your thoughts below — your feedback helps us improve how we collaborate and support you in caring for patients.
Name*

First NameLast Name
Email*
example@example.com
GI Alliance Office Location*
1. Overall, I’ve found the GI Alliance + GI Psychology partnership helpful for supporting patients.*

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
2. How often do you or your team refer patients to GI Psychology?*

FrequentlyOccasionallyRarelyNot yet
3. From your perspective, how interested are patients in connecting with GI Psychology once referred?*

Very interestedOccasionallySomewhat interestedLimited interestUnsure
4. How clear do you feel the referral steps are?*

Very clearSomewhat clearNot clear
5. What aspects of this partnership have been working well for you and your team?*
6. What challenges have you or your team encountered when referring patients to GI Psychology?*
7. What additional information, resources, or tools would help make referrals easier?*
8. Any other questions, concerns, or suggestions for our partnership and ongoing collaboration?*
Thank You!
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