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MSK Physiotherapy attendance Questionnaire
1.
What was the main reason you decided to attend your physiotherapy appointment
Ongoing pain or symptoms
Reduced movement or function
Recommendation from GP/Consultant
Previous benefit from physiotherapy
Symptoms affecting work or daily activities
2.
What influenced you most to keep this appointment today? (tick all that apply)
Advice from a healthcare professional
Desire to reduce pain
Desire to return to normal activities/work/sport
Worsening symptoms
Support from family or friends
Convenience of appointment time/location
Other
3.
Is there anything that made it difficult for you to attend your appointment ?
4.
In your opinion, what are the main reasons someone might not attend a Physiotherapy appointment (please tick all that apply)
Symptoms improved
Forgot the appointment
Pain improved/no longer needed
Work or family commitments
Difficulty with transport or parking
Not wanting to attend this location
Appointment time not convenient
Low confidence that physiotherapy will help
Feeling anxious or unsure about treatment
Long waiting time for treatment
Other
5.
Where was your appoint held?
The Ironstone Centre
Epworth Clinic
West Town Surgery-Barton upon Humber
Winterton Medical Practice
Barnard Court -Brigg
Leisure Centre (any)
Grimsby Wellbeing Centre
Diana Princess of Wales Hospital
Scunthorpe General Hospital
Online appointment
Telephone appointment
Sterling Street Practice- Grimsby
Taylors Avenue-Grimsby
Roxton Practice-Grimsby
Healing Health Centre
GP Surgery (Please specify, which surgery you attended)
6.
Is there anything else you would like to tell us regarding physiotherapy appointments