Capstone Patient Satisfaction Question Title * 1. What location did you receive therapy at? Barkley Blaine Cordata Ferndale Lynden Birch Bay Fairhaven Question Title * 2. Please rate the customer service provided by our front office patient care coordinator Amazing Customer Service Good Customer Service Average Customer Service Below Average Customer Service Poor Customer Service Question Title * 3. What is the name of your Primary Therapist? Jeannett Penner, DPT Aimee Bean, DPT Alyssa Franzen, DPT Anika Tideman, DPT Marc Harrington, DPT Mark Mydan, OTR/L David Grambo, DPT Ben Mahoney, DPT Melissa Evans, DPT Mark Vander Hulst, DPT Cody Vander Berg, DPT Will Hill, DPT Vicky Bale, DPT Daryl Smith, PT Jordan Crim, DPT Justin Marshall, DPT Mikal Olson, OT Jason Schmit, DPT Question Title * 4. How well did your primary therapist listen to your needs? Extremely well Very well Somewhat well Not so well Not at all Question Title * 5. Overall, how would you rate the quality of care you received from your primary therapist? Excellent Very good Good Fair Poor Please include any comments about the quality of care you received. Question Title * 6. How well did your primary therapist answer your questions? Extremely well Very well Somewhat well Not so well Not at all well Question Title * 7. Were you seen by a Physical Therapy Assistant or Occupational Therapy Assistant, If so which one? Vonda VanderYacht, PTA Kristin Foote, PTA Kate McCarthy, PTA Ben Adelman, PTA April Vander Hulst, PTA Katie Sokolik, PTA Sam Dodge, PTA Deborah Molsberry, PTA Mark Turner, PTA Michele Plooster, PTA Tiffany Olliver, PTA I did not see a PTA or COTA Question Title * 8. How well did your therapist assistant listen to your needs? Extremely well Very well Somewhat well Not so well Not at all Question Title * 9. Overall, how would you rate the quality of care you received from the therapy assistant? Excellent Very good Good Fair Poor Question Title * 10. How well did your therapist assistant answer your questions? Extremely well Very well Somewhat well Not so well Not at all well Question Title * 11. How likely is it that you would recommend Capstone to a friend or colleague? Not at all likely Extremely likely 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title * 12. Is there anything we could have done to improve your care? Question Title * 13. If you have Kaiser insurance, please answer the following questions. How was the comfort and cleanliness of our facility? Very Poor Average Excellent N/A Very Poor Average Excellent N/A Question Title * 14. How was your satisfaction with your progress during treatment? Very Poor Average Excellent N/A Very Poor Average Excellent N/A Question Title * 15. Please rate your insurance company; how satisfied are you with their service? Very Poor Average Excellent N/A Very Poor Average Excellent N/A Question Title * 16. Please rate your insurance company; how satisfied are you with the coverage/benefits provided by your insurance company? Very Poor Average Excellent N/A Very Poor Average Excellent N/A Done
