Class Survey

Dear Parents,

Please see below a brief questionnaire regarding the service(s) your child participated in recently with Pop.Earth. The information you are able to provide will go a long way towards putting a study together regarding the merits of alternative therapies. Please help us complete this very important work by filling out the questionnaire below. When you are done simply click the SEND button. *Please note that all information is treated confidentially, as per our Privacy Policy.*

Thank you,
Debbie Stone / Founder

Om Holistic Center- Questionnaire

Please Tell Us About Your Child

Child's Name or Initials (required)

Child's Gender
MaleFemale

Child's Age (required)

Class Attended / Date & Location (required)

Service(s) Received (required)

Parent Email (required)

Please Tell Us About Your Experience

1. What are your current thoughts and opinions on the use of yoga, reiki, and massage therapy as modes of relaxation and increased mind-body connection for the special needs population?

2. What are some presenting issues that led you to choose alternative therapies, such as yoga, reiki, and massage for your child?

3. Is there a noticeable difference in your child’s mood and/or behavior after a yoga session? If so, please describe.

4. Is there a noticeable difference in your child’s mood and/or behavior after a Reiki session? If so, please describe.

5. Is there a noticeable difference in your child’s mood and/or behavior after a massage session? If so, please describe.

6. Are you able to report a difference in typical anxiety driven or self-stimulatory behaviors? (e.g. Obsessive-Compulsive rituals, hand-flapping, self-stimulatory vocalizations). If so, please describe.

7. How frequently would you bring your child to a yoga session if this service were made available on a regular basis?

8. How frequently would you bring your child to a Reiki session if this service were made available on a regular basis?

9. How frequently would you bring your child to a massage therapy session if this service were made available on a regular basis?

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