* 1. It was convenient for me to schedule my appointments.

  Very convenient Convenient Neither convenient or inconvenient Inconvenient Very inconvenient
Convenience

* 2. I fully understood my insurance benefits for physical therapy.

  Strongly agree Agree Neither agree or disagree Disagree Strongly disagree
Insurance benefits

* 3. I felt comfortable with my therapist and he or she was supportive in helping me reach my goals.

  Strongly agree Agree Neither agree or disagree Disagree Strongly disagree
Comfort
Support

* 4. I clearly understood my injury, goals and treatment plan.

  Strongly agree Agree Neither agree or disagree Disagree Strongly disagree
Injury
Goals
Treatment Plan

* 5. I was able to perform my home exercise program with confidence and understood it thoroughly.

  Strongly agree Agree Neither agree or disagree Disagree Strongly disagree
Confidence
Understanding

* 6. I reached my goals and returned to my prior level of functioning.

  Strongly agree Agree Neither agree or disagree Disagree Strongly disagree
Goals
Functioning

* 7. How would you rate your overall experience with Mizuta & Associates?

  Best experience Excellent Good Average Poor Worst experience
Mizuta PT

* 8. If you have been to physical therapy in the past, how would you rate your experience with Mizuta & Associates compared to the other clinics?

* 9. Is there anything you would change about your experience at our clinic? Please let us know how we can improve our future patients' rehabilitation.

* 10. Would you recommend our services to a friend or family member? Why or why not?

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