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* 1. As a part of our continuing commitment to provide the highest quality health care, we are asking patients to participate in this survey. Your cooperation in completing this questionnaire will help us maintain and improve the care you and others receive. We assure you that your responses are strictly confidential.

Thank you in advance for taking the time to share your thoughts about the care you received. We look forward to continuing to serve your health care needs!

Thinking about your visit with the person you saw, how would you rate the following?

  Excellent Very Good Good Fair Poor
How long you waited to get an appointment
Convenience of the office location
Getting through to the office by phone
Length of time waiting at the office
Satisfaction with the treatment provided by the therapist
Explanation of procedures and treatments
Courtesy, respect, friendliness of the reception staff
The quality of my physical therapy care

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* 2. Please share any other comments you have below: