Midwest Rehab Patient Comment Cards

Exit this survey

 

1. Name:

Name:

2. Email:

Email:

3. Therapist I'm seeing today:

Therapist I'm seeing today:

4. Is this your first visit to Midwest Rehab?

Is this your first visit to Midwest Rehab?   Yes No

5. If you called the office, was the phone answered promptly?

If you called the office, was the phone answered promptly?   Yes No

6. Were we able to schedule an appointment to meet your needs?

Were we able to schedule an appointment to meet your needs?   Yes No

7. Were you treated with kindness and respect at all times by the receptionists?

Were you treated with kindness and respect at all times by the receptionists?   Yes No

8. Were you treated with kindness and respect at all times by the therapists?

Were you treated with kindness and respect at all times by the therapists?   Yes No

9. Do you feel your wait to be seen was appropriate?

Do you feel your wait to be seen was appropriate?   Yes No

10. Did we answer your questions completely?

Did we answer your questions completely?   Yes No

11. Would you use our services again?

Would you use our services again?   Yes No

12. Would you recommend us to others?

Would you recommend us to others?   Yes No

13. What did we do well?

What did we do well?

14. What could we do better?

What could we do better?