Y.U. Pilot Survey 2026

Y.U. Pilot Patient Feedback Survey

Please answer based on your experience with the Y.U. pilot.
About You
Full Name

First NameMiddle NameLast Name
Date you received your final plan

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Getting Started
Before you joined, what did you expect Y.U. to do for you? How did the real experience compare?
What surprised you, good or bad?
Which parts of the pilot did you complete?
When you signed up, how clear was it what would happen next?

1

2

3

4

5

1 is Not clear at all, 5 is Completely clear
Did you know which visit came first, which came next, and why?
Did you get the visit roadmap (the guide that shows the order of your visits)?
How easy was it to find visit times that fit your schedule?

1

2

3

4

5

1 is Very hard, 5 is Very easy
Did you have trouble logging in or getting on video?
If you had trouble, what happened?
What was the most confusing or frustrating part of getting started?
Be honest. Did you read the instructions and steps listed on the invitation link?
Comment:
Add any other comments that you have here.
The Intake Forms
About how long did the intake forms take you, in total?
Did you answer/address every question or section in the form?
What prevented you from completing the form?
How did filling out the forms make you feel?

Other
Tell us more
Now that you are done, look back. Did the forms make sense? Did you see your answers show up in your visits and your plan?

1

2

3

4

5

1 is Not at all, 5 is Completely
Which questions felt pointless? What should we have asked that we did not?
Comment:
Add any other comments that you have here.
Before Each Visit

How ready were you for each visit?

Rows	Fully Ready	Partly Ready	Not Ready	Did not have
Coaching Sesssions
Medical Session
Nutrition Session
Physical Therapy Session
Fitness Session
Professional Career Coaching

Be honest. How many of our emails and messages did you actually read before your visits?
What is the best way to reach you with visit instructions?

Other

We are thinking about adding these. Would they help you?

Rows	Would help a lot	Might help	I would skip it
A short welcome video when you sign up that shows how Y.U. works, step by step
A 30 second video from your clinician, sent by e-mail or text before each visit: who they are and how to get ready
A text or e-mail 1 hour before each visit with your link and what to have ready

What do you wish someone had told you before any of your visits?
For example: what to wear, how much space you need, equipment, how long it runs, what the visit is for.
Comment:
Add any other comments that you have here.
Your Visits, One at a Time

Rate each visit you had. We want to know if each visit did its job. 1 = No, not at all. 5 = Yes, completely.

Coaching: keep doing
Coaching: change

Medical Session

Rows	1	2	3	4	5
I felt heard
They already knew my background (I did not start from zero)
Their feedback was clear
Their feedback was realistic for my life
I left knowing exactly what to do next
I left more confident and in control of my health
The visit was worth my time

Medical: keep doing
Medical: change

Nutrition Session

Rows	1	2	3	4	5
I felt heard
They already knew my background (I did not start from zero)
Their feedback was clear
Their feedback was realistic for my life
I left knowing exactly what to do next
I left more confident and in control of my health
The visit was worth my time

Nutrition: keep doing
Nutrition: change

Physical Therapy Session

Rows	1	2	3	4	5
I felt heard
They already knew my background (I did not start from zero)
Their feedback was clear
Their feedback was realistic for my life
I left knowing exactly what to do next
I left more confident and in control of my health
The visit was worth my time

Physical therapy: keep doing
Physical therapy: change

Fitness Session

Rows	1	2	3	4	5
I felt heard
They already knew my background (I did not start from zero)
Their feedback was clear
Their feedback was realistic for my life
I left knowing exactly what to do next
I left more confident and in control of my health
The visit was worth my time

Fitness: keep doing
Fitness: change
One team, or five appointments?

Y.U. is supposed to feel like one team working one plan. Tell us if it did.
Did Y.U. feel like one program or five separate appointments?

1

2

3

4

5

1 is Five separate appointments, 5 is One team, one plan
How often did you have to repeat the same information to different clinicians?
What did you have to repeat? (optional)
Did advice from one clinician ever clash with advice from another?
What was it?
Did it feel like your clinicians were talking to each other about you?

1

2

3

4

5

1 is Not at all, 5 is Clearly yes
What made you think so? (optional)
Did you have a Professional Career and Leadership Session with Kevin?
How much did work stress or career pressure affect your health (sleep, eating, exercise, energy)?

1

2

3

4

5

1 is Not at all, 5 is A great deal
How useful was the session for you?

1

2

3

4

5

1 is Not useful, 5 is Very useful
Did you leave with one specific thing to do?
If yes, what was it?
Since the session, have you actually done it?
Did it connect to the rest of your Y.U. plan(sleep, nutrition, fitness, medical)?

1

2

3

4

5

1 is Felt separate, 5 is Clearly connected
Did it overlap with your coaching visit with your Will Engineer?
What would have made the session more valuable?
How would you feel if Y.U. no longer offered Career and Leadership Coaching?
How should Y.U. offer it?
If it were an add-on, what would you pay for one session?
$ per session:
How often would you use it?
Comment:
Add any other comments that you have here.
The brain test (Creyos)

The online test that measured memory, focus, and thinking speed.
Did you take the test?
If no, why not?
Did it make you feel nervous? Was it too much? Did you forget to do it?
How was taking the test?
Did the results or feedback mean something to you?

1

2

3

4

5

1 is Meant nothing, 5 is Very useful
Would you retake it to track your brain health over time?
What would make you more willing to retake it?
Comment:
Add any other comments that you have here.
Your score and your plan

Answer this section after you have gone over your final plan with us.
Do you understand your Y.U. Score and what it means?

1

2

3

4

5

1 is Not at all, 5 is Completely
Does the score match how you feel about your health right now?

How well does your final plan work for you?

Rows	1	2	3	4	5
It reflects what I told you matters most to me
The steps are clear
The steps fit my real schedule
I know what to do if I fall off the plan
I have already started using it

What would make the plan easier to follow? Pick your top two.
What is missing or confusing in your plan? (optional)
Comment:
Add any other comments that you have here.
Value, price, and what comes next
What part of the pilot was most valuable to you, and why?
What took time or effort without giving you enough back? What felt unnecessary?
How confident are you that Y.U. can help you make real progress on your main goals?

1

2

3

4

5

1 is Not confident, 5 is Very confident
If we opened enrollment tomorrow, what would you do?
What concerns, if any, would make you hesitate to continue with Y.U.?
Based on what you experienced, fill in a monthly price for each. There is no right answer. Your gut number is what we want.
A great deal, easy yes ($ per month)
Fair, I would pay it ($ per month)
Getting expensive, I would think hard ($ per month)
Too expensive, I would walk away ($ per month)
What would Y.U. need to include for that price to feel worth it?
How likely are you to recommend Y.U. to someone with goals like yours? (0 = Not at all likely, 10 = Extremely likely)
Comment:
Add any other comments that you have here.
Last word
If you could change one thing before we launch, what should it be?
Is there anything we did not ask that you want us to know?
Are you open for a 15 minute follow-up about your answers?
Would you give us a testimonial to use on social media or our website?
Comment:
Add any other comments that you have here.
That is it. Thank you. You are helping build this from the ground up, and we do not take that lightly.
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Y.U. Pilot Patient Feedback Survey

About You

Getting Started

The Intake Forms

Before Each Visit

Your Visits, One at a Time

One team, or five appointments?

The brain test (Creyos)

Your score and your plan

Value, price, and what comes next

Last word