Opinion meter tool
Opinion meter tool
1. Please indicate how long you have been in therapy.
- 10 days or less
- more than 10 days
2. How satisfied are you with the competence of your therapist?
- Very Satisfied
- Satisfied
- Unsatisfied
- Very unsatisfied
3. Is your therapist(s) kind, courteous, and supportive?
- Yes
- No
4. How satisfied are you with the way your treatment was explained?
- Very Satisfied
- Satisfied
- Unsatisfied
- Very Unsatisfied
5. How satisfied are you with the assistance you receive from the front desk staff?
- Very Satisfied
- Satisfied
- Unsatisfied
- Very Unsatisfied
6. Are the front desk and support staff kind, courteous, and supportive?
- Yes
- No
7. Are you satisfied that therapy has been beneficial in improving your condition?
- Very Satisfied
- Satisfied
- Unsatisfied
- Very Unsatisfied
8. Would you recommend outpatient therapy at the Physical Rehab and Sports Injury Center to others?
- Yes
- No
9. What is your therapist’s name: (please enter 2-digit number, as shown before therapist’s name).
Source: Provena St. Joseph Physical Rehab & Sports Injury Center, Joliet, IL.
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