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Question marked with * are mandatory.

FIRST IMPRESSIONS SURVEY

Note: This survey is in the draft phase, is under review and may significantly change!
Q1. Which location will you be visiting for your Physical Therapy?
Q2. Have you had Physical Therapy Treatment Before?
 
 
 
Q3. What was your first impression of our clinic?
Q4. How quickly we scheduled your first visit: *
 
 
 
 
 
Q5. How did you hear about our clinic? *
 
 
 
 
 
If Other, how did you hear about us?
Q6. Friendliness of the staff who greeted you and took care of you at your first visit : *
 
 
 
 
 
Q7. How well your therapist clearly explained your condition and future treatment plan : *
 
 
 
 
 
Q8. How well your insurance questions were answered : *
 
 
 
 
 
 
Q9. How well your therapist explained your home exercise program : *
 
 
 
 
 
Q10. Add other comments or insights below that could help us improve your first experience with our clinic.
Please enter the following text in the box