1327 Superior St Suite 103, Sandpoint, ID 83864
Please circle the appropriate number on all questions below. 0 as the least/never to 3 as the most/always.
INSTRUCTIONS:
The purpose of this questionnaire is to identify difficulties
that you may be experiencing. Please answer every
question, do not skip any questions. Follow the 0 to 4 key,
and select which best fits for all of your answers.
KEY:
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Monday
Closed
Tuesday
8:00 am - 6:00 pm
Wednesday
Thursday
Friday
Saturday
Sunday
1327 Superior St Suite 103Sandpoint,ID 83864