Patient Questionnaire

Which therapist/s provided care?: *

Customer Care

Did your therapist begin treatment promptly?:

Yes

Was the professional respect you received from your therapist acceptable?:

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Did you feel comfortable with your therapist? :

Yes

If you saw more than one therapist, was your care provided in a professional manner? :

Yes

Professional Services

Did you receive an independent exercise and care program?:

Yes

Did your therapist address your questions to your satisfaction?:

Yes

Did your therapist explain the results of your initial examination with you?:

Yes

Did you feel comfortable with your therapist's competence and skills? :

Yes

Scheduling

How many days from the time you saw your MD until you contacted OPTM? :

How many days between the time you contacted OPTM and were scheduled for an appt? :

Were you called 1 business day prior to your initial evaluation? :

Yes

Were you able to schedule convenient subsequent appointments? :

Yes

Were you given a print out of all your appointments? :

Yes

General

Did the type of care you received meet your expectations? :

Yes

Was the physical therapy care you received beneficial? :

Yes

Would you return for care from your therapist?:

Yes

If you saw more than one therapist, was this acceptable to you?:

Yes

Would you recommend our clinic? :

Yes

How could we have made your experience more enjoyable? :