private practice physical therapy
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  private practice physical therapy  
 
 

 

Your satisfaction with the care you received during your visit to Physical Therapy First, LLC is our highest priority.  Please let us know how we are doing so that we can improve our services to you.  Would you take a minute or two to complete and submit this survey?  Your ratings and comments are greatly appreciated.

Rating Scale
5- Very Satisfied  4- Satisfied  3- Neutral  2- Dissatisfied  1- Very Dissatisfied

Please rate the following by selecting the number which best represents your response:

Staff Attitude

1. Courtesy of office personnel

2. Courtesy of therapist or trainer

3. Courtesy of aide

4. Concern of therapist for your well being
 
 

Professional Demeanor

1. Clinician introduced him/herself to me personally

2. The evaluation & treatment I received were adequately explained (i.e., expectations, time frames, etc.)

3. Responses were provided for my questions and concerns.

4. Respect for my dignity and feelings was handled appropriately. 

5. The clinician was courteous, respectful and seemed concerned about me.
 
 

Quality of Service

1. My initial evaluation was scheduled within 48 hours or within my desired time frame.

2. Appointments were scheduled to my convenience.

3. When I arrived for my appointment, the service began promptly.

4. I had trust and confidence in my clinician.

5. Service and attention was consistent.

6. My clinician communicated with my doctor regarding my therapy progress.
 
 

Facilities

1. Cleanliness of facility

2. Atmosphere

3. Equipment type and availability

4. Parking

5. Convenience of location
 
 

Other

1. Cost of treatment

2. Handling of insurance by clinic staff

3. Handling by billing department

4. Timeliness and accuracy of billing
 
 

Overall

1. What was your overall impression of Physical Therapy First?

2. What could we have done to make your visit better?

3. What did you like most about Physical Therapy First?

4. What did you like least about Physical Therapy First?

5. If any individual gave you outstanding attention, please let us know so we can commend that person.  Also, if you wish to share any constructive criticism, let us know, and we will seek appropriate solutions.

6. Please include any additional comments.

7. Would you refer someone to Physical Therapy First? Yes    No
Why or why not?

 

The following fields are Optional.  Thank you for your time.

Name:
Company:
Address:
City:
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ZIP:
Telephone:
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E-Mail Address:

 
 

  
 
 
 
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