Client Satisfaction Survey
We would like to ask you about your experience regarding your last visit to our Clinic. Thank you for helping us continue to improve the care we provide for our clients.
1.
Overall, how satisfied were you with your last visit to our Clinic?
Extremely satisfied
Very satisfied
Somewhat satisfied
Not so satisfied
Not satisfied at all
2.
Overall, how would you rate the service you received at the reception area of our Clinic?
Excellent
Very good
Good
Fair
Poor
3.
Did your appointment with your therapist start early, late or on time?
10 or more minutes early
Less than 10 minutes early
On time
Less than 10 minutes late
10 or more minutes late
4.
How well did your therapist listen to your needs?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
5.
How well did your therapist explain your treatment options?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
No treatment was required
6.
How well did your therapist explain your follow-up care?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
No follow-up care was required
7.
On a scale of 0 to 10,
How likely is it that you would recommend therapist to a friend or family member?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
8.
How satisfied are you with the cleanliness and appearance of our Clinic?
Extremely satisfied
Very satisfied
Somewhat satisfied
Not so satisfied
Not satisfied at all
9.
Is there anything we could have done to improve your last visit?