Patient Satisfaction Survey - Spectrum Physical Therapy

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Patient Satisfaction Survey

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Your Name (First and Last)

Name of Therapist

(First and Last)

Treatment Clinic Location *

Fluvanna-Lake Monticello Clinic

Greene-Ruckersville Clinic

Forest Lakes-Hollymead Clinic

Orange Clinic

Pantops Clinic

Culpeper Clinic

Zion's Crossroads-Spring Creek Clinic

Name of Therapy Assistant/Technician

How Did Hear About SPECTRUM Physical Therapy

Please Specify

Because we strive to deliver the best possible physical therapy services, we are interested in learning from patients how we might improve or enhance our services. Please take a few minutes to mark the answer that best represents your impression. Thank you for your feedback!

The Clinic Facility Was Clean

Parking Was Available For Me

The location of the clinic was convenient

The staff was courteous and professional.

The clinic scheduled appointments at convenient times

My first visit for physical therapy was scheduled quickly

My physical therapist was courteous and professional

My physical therapist understood my problems or condition

My privacy was respected during my physical therapy care

The instructions my physical therapist gave me were helpful

I was satisfied with the treatment provided by my physical therapist

My physical therapy tech was courteous and professional

I was satisfied with the services provided by my physical therapist tech(s)

I was satisfied with the overall quality of my physical therapy care

I was seen promptly when I arrived for treatment

I would return to this clinic if I needed physical therapy again

I would recommend this clinic to family or friends

Which statement best describes your experience?

Spectrum Physical Therapy EXCEEDED My Expectations

Spectrum Physical Therapy MET My Expectations

Spectrum Physical Therapy DID NOT MEET My Expectations

Comments / Suggestions:

Please check this box if we can use your comments on our website or in other marketing materials

Yes

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Name

Phone Number

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Email Address

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