Patient Survey First Name(Required)Last Name(Required)Email(Required) Who was your Therapist?Was our staff friendly and helpful on the phone with you?*(Required) N/A 1 2 3 4 5 Have all office staff members been courteous and helpful?*(Required) N/A 1 2 3 4 5 Were your benefits adequately explained to you?*(Required) N/A 1 2 3 4 5 Have the office and treatment areas always been clean and comfortable?*(Required) N/A 1 2 3 4 5 Did the clinic have scheduled appointments at convenient times for you?*(Required) N/A 1 2 3 4 5 Was it easy to schedule your appointments?*(Required) N/A 1 2 3 4 5 Were you always seen promptly when you arrived for treatment?*(Required) N/A 1 2 3 4 5 Was the check-in process prompt and efficient?*(Required) N/A 1 2 3 4 5 Was your therapist courteous and helpful?*(Required) N/A 1 2 3 4 5 Did your physician/therapist fully explain your problem and how they would treat it?*(Required) N/A 1 2 3 4 5 Did you receive a home program and were you instructed properly in activities to do at home?*(Required) N/A 1 2 3 4 5 Would you recommend this facility to your friends or family?*(Required) N/A 1 2 3 4 5 Will you return to our practice if future care is needed?*(Required) N/A 1 2 3 4 5 How was your overall satisfaction with your experience in therapy?*(Required) N/A 1 2 3 4 5 Please share your comments:
