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.

Name

Optional

This is a required question

Who was your main therapist?

This is a required question

The staff was always courteous, friendly, knowledgeable, and professional.

This is a required question

My initial evaluation was thorough and informative.

This is a required question

I was pleased with my ability to progress toward my treatment goals result of the treatment I received.

This is a required question

The staff was available to answer my questions and/or directed me to the most appropriate staff to answer my question.

This is a required question

I was able to get preferred treatment times, and informed of options when my preference coincided with other patients' choice of appointments.

This is a required question

The billing/insurance procedure was clearly described by the office staff.

This is a required question

If I need physical therapy in the future, I would return to this facility.

This is a required question

What suggestions or comments do you have to help us improve our services?

regarding billing, appointments, treatment, care by aides/therapists, clinic, etc.

This is a required question

If your own words, please tell us how physical therapy has helped you.

This is a required question

E-mail Address:

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Would you like to receive our newsletter?

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If you have anything negative to convey, may we contact you to learn more and improve our patient care?

This is a required question

Patient Satisfaction Survey

Thank you for your time and feedback so that we may better our clinic!