P.O.S.T. Patient Satisfaction Survey

We are conducting the following survey in order to determine ways in which we can improve our clinic and the care we provide. We are interested in your honest opinions – good or bad – and hope you will take the time to fill out this form, and submit with the button at the bottom of the page.

Therapist you saw the most:

Town you live in:

Why did you choose to come to POST for physical therapy?
Please check all that apply.

Orthopedic MD Referral
        Name:
Insurance Requirement
Convenient Location
Telephone / Yellow Page Directory
PCP Referral
       Name:
Other
Previous Treatment at POST
Family or Friend Referral
        Name:

Please estimate the length of time before you were able to get an appointment for an evaluation.

Within 24 Hours
1-3 Days
4-7 Days
1-2 Weeks
Greater than 2 Weeks

Were you able to schedule follow-up appointments convenient to fit your schedule?

Yes
Most of the Time
Occassionally
No

Please take the time to rate the following:

1 = Excellent
2 = Good
3 = Fair
4 = Poor

Office / Reception Staff:

Courtesy (in person and by phone)	1 2 3 4
Knowledge of your insurance benefits	1 2 3 4
Explanation of Policies and Forms	1 2 3 4
Registration/Appointment Scheduling	1 2 3 4
Overall efficiency	1 2 3 4

Clinical / Therapist Staff:

Appointment began at scheduled time	1 2 3 4
Explanation of diagnosis/treatment	1 2 3 4
Appropriate goals set for treatment	1 2 3 4
Aides/student services	1 2 3 4

Facility

Privacy	1 2 3 4
Cleanliness	1 2 3 4
Equipment Availability	1 2 3 4
Overal Opinion	1 2 3 4

Where you satisfied with the outcome of your treatment at time of discharge from Physical Therapy?

Yes
No, I had to stop therapy for insurance related reasons
No, my symptoms did not change significantly since beginning therapy

Would you return to POST for future treatment?

Yes
No

Would you recommend us to others?

Yes
No

Please make any additional comments or suggestions regarding the quality of care given at POST – regarding the facilities, the office staff, the clinical staff, or any other issues.

Thank you very much for taking the time to provide us with your input. We will be carefully reading and considering all surveys returned, in an effort to better deliver the excellent care that each of you deserve.

POST Physical Therapy Staff