How did you enjoy your arts experience?

How did you enjoy your arts experience?

By sharing, you give us permission to use your testimonial in our promotional materials. We will not use your name unless you include it in your testimonial.
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Name (optional)

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I am a:*

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I identify as:

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Date

MonthDayYear
Date
Type of program:*

Bedside ArtBedside MusicBedside WritingStaff ArtStaff MusicStaff WritingVirtual ArtVirtual MusicVirtual Writing
Location of program:*

UT HealthVAStone Oak MethodistStone Oak RehabNortheast MethodistVirtualMedical Center MethodistMetro MethodistSpecialty MethodistTexsan Methodist
Is this your first time with Hearts Need Art?

YesNo
The activity improved my mood

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5

1 is Strongly Disagree, 5 is Strongly Agree
The activity took my focus off my pain (Leave blank if N/A)

1

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5

1 is Strongly Disagree, 5 is Strongly Agree
The activity made me feel less isolated.

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5

1 is Strongly Disagree, 5 is Strongly Agree
I would recommend this program to others.

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1 is Strongly Disagree, 5 is Strongly Agree
The facilitator was receptive and respectful to my needs and responses.

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1 is Strongly Disagree, 5 is Strongly Agree
The activity improved my overall impression of the hospital. (if applicable)

1

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5

1 is Strongly Disgree, 5 is Strongly Agree
Hearts Need Art increased the likelihood that I will recommend this hospital. (if applicable)*

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5

1 is Strongly Disagree, 5 is Strongly Agree
Written testimonial/comments on your arts experience:
Filmed testimonial/comments on your arts experience:

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