Instructions: Please rate the service you received from our practice. Select the response that best describes your experience. If a question does not apply to you, please skip to the next question. There is also space provided for your questions, concerns, or comments.
Please Rate on a scale of 1-5: 1-Very Poor, 2-Poor, 3-Fair, 4-Good, 5-Very Good
Please Rate on a scale of 1-5: 1-Very Poor, 2-Poor, 3-Fair, 4-Good, 5-Very Good
During your visit, your care was provided by a Doctor and Therapist. Please answer the following questions with that health care provider in mind. Please rate on a scale of 1-5; 1-Very poor, 2-Poor, 3-Fair, 4-Good, 5-Very good.