Patient Survey Form

Thank you for choosing Greenhaus Physical Therapy. We strive hard to provide outstanding service to our patients. We value your inputs and will appreciate if you could provide feedback so we can continue to improve. Thank you for your time.




Please rate the survey questions below based on the following scale.
1. Very Dissatisfied 2. Dissatisfied 3. Neutral 4. Satisfied 5. Very Satisfied

1. My Privacy was respected(*)

2. My Physical Therapist was courteous(*)

3. My Physical Therapist understood my problem or condition(*)

4. My Physical Therapist explained my treatment in a manner I could understand(*)

5. My Physical Therapist spent enough time with me(*)

6. Administrative staff at the clinic was friendly, courteous, and professional(*)

7. It was easy to schedule visits after my first appointment(*)

8. The clinic scheduled appointment at convenient times(*)

9. I was seen promptly after I arrived for my appointment(*)

10. How satisfied were you with the cleanliness and atmosphere at the clinic?(*)

11. How satisfied were you with the equipment type and availability at the clinic?(*)

12. How satisfied were you with the treatment provided at the clinic?(*)

13. How would you rate your overall experience at the clinic?(*)

14. I would return to the clinic, if I required Physical Therapy in future(*)

15. I would recommend this clinic to family and friends(*)

16. What did you like the least about your experience at the clinic?

17. What did you like the most about your experience at the clinic?

18. If we could improve one thing to provide you with better experience next time, what would it be?

Please check the box if you do not agree to have your comments placed anonymously on our website Yes