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Marshfield Medical Dickinson Rehab Survey
1.
What location did you receive therapy?
Kingsford
Niagara
Norway
Florence
2.
The administrative (front desk) staff was professional, courteous, and friendly.
Yes
No
Unsure
3.
The therapist was on time for my appointments
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
4.
The clinic was clean, organized, and comfortable.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
5.
The therapist helped me understand my injury or condition.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
6.
The therapist provided me with a home exercise program to allow me to continue to progress on my own.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
7.
To what degree did the rehab you received improve your condition?
Much better
Better
About the same
Worse
Much worse
8.
I would recommend UP Rehab services to friends and family.
Yes
No
Unsure
9.
If you require therapy in the future, how likely are you to use our services?
Very likely
Somewhat likely
Neither likely nor unlikely
Somewhat unlikely
Very unlikely
10.
Which factors influenced you to choose UP Rehab? (Please check all that apply)
Family/Friend
Former Patient
Physician recommended
TV advertising
Radio advertising
Newspaper advertising
Internet search (i.e., Google)
Phonebook
Facebook
11.
May we contact you regarding your feedback?
Name
Email Address
Phone Number
12.
Do we have your permission to send you helpful information relating to optimal health and therapy?
Yes
No
13.
To help us serve you better, please use the space below to provide additional feedback.