Feedback Survey

Patient Satisfaction Survey / Quality Improvement Suggestions

In order to continuously improve the quality of our service we are asking that you complete the following survey. Please feel free to comment on areas where you feel we can improve and things you feel we are doing well based on your experience at our Center. This survey is confidential and your identity will only be known by the management.

All fields are optional.

About You
Please Rate
Ease of making your first appointment:

Ease of making your follow up appointment:

Helpfulness and courtesy of office staff:

Help understanding your benefits and billing information:

Supervision and direction by your Physical Therapist:

Satisfaction with your Physical Therapist’s Care:

Comfort with Student Physical Therapist (if applicable)

Degree to which Physical Therapy helped your condition:

Overall satisfaction with your experience at BUPTC:

Appearance/Cleanliness of the Clinic:

Would you use the Internet to find a PT provider?

Would you refer a family member or friend to us?