Patient Satisfaction Survey

ProCare Therapy Services values your feedback, as it allows us to improve our services and to provide better care. Your answers may also be used for marketing purposes.

INSTRUCTIONS:

Please rate your experience as a patient at the ProCare Therapy Services. For each question below, pick the answer that best represents your feelings.

Patient Satisfaction Survey

First Name (Optional)
Last Name (Optional)

Support Staff

Professionalism and friendliness
Ease of scheduling appointments
Timeliness in responding to questions
Explanation of your billing and payment
Overall quality of support staff

Your Therapist

Professionalism and friendliness
Educating you on your injury or condition
Responding appropriately to your concerns
Beginning treatment at your scheduled time
Overall quality of your therapist

Clinic and Facility

Location
Condition and cleanliness of clinic
Quality of equipment used during treatment
Overall comfort and appeal

Overall Impression

Overall quality of this clinic
Overall quality of other professional staff

General Questions

Were your goals for seeking treatment met?
Did your therapist provide a home program?
Does our clinic offer sufficient hours?
Would you return to this clinic for future care?
Would you recommend this clinic to others?

How did you hear about us?

Please choose one...
If Other, please list:

Please provide additional comments you would like to share. What did you like best about your experience? What would you like to see us improve?

Comments

Verification

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