Patient Satisfaction Survey
Hands On Therapy
Please rate the following:
How satisfied are you with the booking process?
Not Satisfied
1
2
3
4
5
6
7
8
9
Very Satisfied
10
1 is Not Satisfied, 10 is Very Satisfied
How satisfied are you with check in process?
Not Satisfied
1
2
3
4
5
6
7
8
9
Very Satisfied
10
1 is Not Satisfied, 10 is Very Satisfied
How would you rate the cleanliness and appearance of our facility?
Not Satisfied
1
2
3
4
5
6
7
8
9
Very Satisfied
10
1 is Not Satisfied, 10 is Very Satisfied
Location(s) you attended:
Pikesville
Catonsville
White Marsh
How satisfied are you with the wait time?
Not Satisfied
1
2
3
4
5
6
7
8
9
Very Satisfied
10
1 is Not Satisfied, 10 is Very Satisfied
How satisfied are you with the kindness, friendliness, and professionalism of the staff?
Not Satisfied
1
2
3
4
5
6
7
8
9
Very Satisfied
10
1 is Not Satisfied, 10 is Very Satisfied
How would you rate the overall care you received from the therapist?
Not Satisfied
1
2
3
4
5
6
7
8
9
Very Satisfied
10
1 is Not Satisfied, 10 is Very Satisfied
By considering your overall experience, how likely are you to recommend Hands On Therapy to a family member/friend?
Not Likely
1
2
3
4
5
6
7
8
9
Very Likely
10
1 is Not Likely, 10 is Very Likely
How can we improve our service?
Please share any comments/suggestions
Name (Optional)
First Name
Last Name
Submit
Should be Empty: