Survey

About you
Who Treated you?*
What were you treated for?*
When did your treatment start?*
Date Format: DD slash MM slash YYYY
Where were you treated?*
Please tell us where*
Were staff able to answer any of your questions relating to storage of your personal data?
- Yes
- No
- N/A
- I Didn't Ask

Before your treatment
Did your physiotherapist obtain consent before they began your treatment?*
- Yes
- No
How would you rate our communication with you prior to your appointment?*
Very Poor Poor Average Good Very Good
How would you rate the choice and flexibility of the appointment times offered to you?*
Very Poor Poor Average Good Very Good
How would you rate the approachability of our staff?*
Very Poor Poor Average Good Very Good
How would you rate your involvement in decisions about your physiotherapy treatment?*
Not enough Almost enough Plenty Too Much
How clean was the treatment room and waiting area?*
Very Poor Poor Average Clean Very Clean

About our staff
Our business goals are to promote a physiotherapy clinic with friendly, knowledgeable and informative staff who offer specialist treatment tailored to your needs with flexible appointment times.
Specialist treatment tailored to your needs*
Very Poor Poor Average Good Very Good
Staff knowledgeable and Informative*
Very Poor Poor Average Good Very Good
Friendly*
Very Poor Poor Average Good Very Good
Flexible appointment times*
Very Poor Poor Average Good Very Good
Would you recommend us to people?*
Yes No
Any other comments which may help to improve our service - If you would like a response to your feedback, please leave your name and contact details:
We only share notes about you when appropriate for your continued care. Do you feel we are respecting your confidentiality*
Yes No
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About you