Discharge SurveyThank you for taking the time to fill out our survey, we’d love to hear about your experience! Name * First Name Last Name During Your Visit * Courtesy of staff at the front desk was excellent. Strongly Disagree Disagree Neutral Agree Strongly Agree Length of wait before going to treatment area was timely. Strongly Disagree Disagree Neutral Agree Strongly Agree Comfort and pleasantness of treatment area was excellent. Strongly Disagree Disagree Neutral Agree Strongly Agree Who was your therapist? * Tyler Shane Michelle Emily Bobby Your Therapist * Can view things from my perspective (see things as I see them) Strongly Disagree Disagree Neutral Agree Strongly Agree Understands my emotions, feelings and concerns Strongly Disagree Disagree Neutral Agree Strongly Agree Was knowledgeable and clearly explained my condition/injury to me Strongly Disagree Disagree Neutral Agree Strongly Agree Was skillful in treating me Strongly Disagree Disagree Neutral Agree Strongly Agree Comments Appointment Scheduling * It was easy communicating and scheduling my appointments. Strongly Disagree Disagree Neutral Agree Strongly Agree The team member who scheduled my appointment was courteous. Strongly Disagree Disagree Neutral Agree Strongly Agree Comments How likely are you to recommend our clinic to your friends and relatives? * 1 2 3 4 5 What is an area of improvement we can work on? Additional Comments Thank you for taking the time to fill out our survey! We appreciate guests like you!
