We would like to ask you about your experience regarding your visits to our PT clinic. Thank you for helping us continue to improve the care we provide for our patients.

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* 1. Which therapist(s) did you work with the most?

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* 2. Overall, how satisfied were you with your visits to our PT clinic?

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* 3. Overall, how would you rate the service you received at check-in and check-out at the office?

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* 4. Did your appointment with your therapist start early, late or on time?

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* 5. How well did your therapist listen to your needs?

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* 6. How well did your therapist explain the plan of care and process while attending PT?

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* 7. Were all of your questions and/or concerns addressed properly by the therapist?

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* 8. How satisfied are you with the cleanliness and appearance of our facility?

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* 9. How likely is it that you would recommend your provider to a friend or family member?

Not at all likely
Extremely likely

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* 10. Is there anything we could have done to improve on from your time in PT or something that stood out?

T