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 Name
Last Name
Email
*
example@example.com
GI Alliance Office Location
*
1. Overall, I’ve found the GI Alliance + GI Psychology partnership helpful for supporting patients.
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Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
2. How often do you or your team refer patients to GI Psychology?
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Frequently
Occasionally
Rarely
Not yet
3. From your perspective, how interested are patients in connecting with GI Psychology once referred?
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Very interested
Occasionally
Somewhat interested
Limited interest
Unsure
4. How clear do you feel the referral steps are?
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Very clear
Somewhat clear
Not clear
5. What aspects of this partnership have been working well for you and your team?
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6. What challenges have you or your team encountered when referring patients to GI Psychology?
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7. What additional information, resources, or tools would help make referrals easier?
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8. Any other questions, concerns, or suggestions for our partnership and ongoing collaboration?
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Thank You!
Submit
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