Thank you for choosing Spooner/Hayward PT and Wellness! We would like to ask you about your experience while in our care. Thank you for helping us continue to improve the care we provide for our patients by taking time to answer these 20 questions.

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* 1. Your Age:

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* 2. Your Sex:

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* 4. Was this your first experience with Physical Therapy?

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* 5. Overall, how would you rate the service you received at the reception area of our office?

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* 6. How satisfied are you with the cleanliness and appearance of our facility?

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* 7. Which provider/providers did you receive therapy services from?

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* 8. Please indicate what body part/parts received treatment?

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* 9. Did your appointment with your provider start early, late or on time?

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* 10. How well did your provider listen to your needs?

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* 11. How well did your provider explain your treatment options?

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* 12. Your Physical Therapist's/Provider's understanding of your problem/condition

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* 13. How well did your provider explain your follow-up care?

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* 14. Overall, how satisfied were you with your physical therapy/wellness services at either our Spooner or Hayward location?

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* 15. How likely is it that you would recommend your provider to a friend or family member?

Not at all likely
Extremely likely

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* 16. Is there anything we could have done to improve your treatment services?

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* 17. Ability to schedule subsequent physical therapy appointments

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* 18. How did you hear about Spooner/Hayward Physical Therapy and Wellness?

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* 19. I would return to this facility if I require physical therapy again

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* 20. I enjoyed the atmosphere of Spooner/Hayward Physical Therapy and Wellness (i.e. staff, music, cleanliness)

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* 21. Would you be willling to provide us with a patient testimonial? If so, please comment below-

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