Patient Satisfaction Survey
Please answer the questions as candidly as possible so that we may improve to better help you and others in the future. If you have any questions regarding the survey, please feel free to ask, call, or email as we would love to help you.
Who was your main therapist? *
The clinic was comfortable and clean. *
I was pleased with the quality of my care. *
The staff was always courteous, friendly, knowledgeable, and professional. *
My initial evaluation was thorough and informative. *
My treatment plan was clearly explained to me. *
I was pleased with my ability to progress toward my treatment goals result of the treatment I received. *
The staff was available to answer my questions and/or directed me to the most appropriate staff to answer my question. *
I was able to get preferred treatment times, and informed of options when my preference coincided with other patients' choice of appointments. *
My time spent in the waiting room was minimal. *
The billing/insurance procedure was clearly described by the office staff. *
If I need physical therapy in the future, I would return to this facility. *
What suggestions or comments do you have to help us improve our services?
regarding billing, appointments, treatment, care by aides/therapists, clinic, etc.
If your own words, please tell us how physical therapy has helped you.
E-mail Address: *
Would you like to receive our newsletter?
If you have anything negative to convey, may we contact you to learn more and improve our patient care?
Clear selection
Thank you for your time and feedback so that we may better our clinic!
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy