We would appreciate it if you would take a few minutes to complete the following survey. The information you provide will assist us in achieving our goal of 100% patient satisfaction.
Patient Name (Optional)
Therapist Name
 
Please rate the following based upon your experience:

Courtesy of Staff:

Front Office/Scheduling
Therapist Aide
Billing Staff
 

Communication regarding financial/Insurance Information

Cleanliness of facility

Treatment plan and questions were answered by my therapist

Efficiency of treatment sessions
Sensitivity to my pain or discomfort
Overall care and service received
My home exercise program was clearly explained
Therapy/exercise played an important role in my return to prior activity level Yes No
Were calls returned in a timely manner? Yes No
Your waiting time was

Would you refer a friend to OSR Physical Therapy?

Yes No
We welcome any additional comments you may have:
Thank you!