Physical Solutions Patient Information Form

Patient Satisfaction Survey Please fill out this form, then click the button below. You may also fill out the form, print it, and bring it in. If you'd like to subscribe to our email newsletter, please provide your email address.
Name:	Email:
Over the course of your treatment, how satisfied were you with the following items?
Convenience of the location of the office	very somewhat neutral dissatisfied
Getting through to the office by phone	very somewhat neutral dissatisfied
The courtesy and consideration provided by the office staff	very somewhat neutral dissatisfied
The ability to schedule a convenient appointment time	very somewhat neutral dissatisfied
Length of time in the waiting area	very somewhat neutral dissatisfied
The information you were given about your condition and treatment plan	very somewhat neutral dissatisfied
Your primary therapist or practitioner	very somewhat neutral dissatisfied
Your overall therapy and care	very somewhat neutral dissatisfied
Your overall rating of this facility	very somewhat neutral dissatisfied
Your condition upon discharge	very somewhat neutral dissatisfied
How likely would you be to return to Physical Solutions for future care?	very somewhat neutral would not return
Other comments?