Customer Satisfaction Survey

We would appreciate if you could take a few minutes to let us know how we are doing. This information allows us to improve our services and provide better care.

For each question below, pick the answer that best represents your feelings.

Administration Staff Excellent Good Fair Poor Terrible N/A
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
Physiotherapy Staff Excellent Good Fair Poor Terrible N/A
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
Clinic and Facilities Excellent Good Fair Poor Terrible N/A
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
5 4 3 2 1 0
General Questions
0-10min 10-20min 20+min
0-10min 10-20min 20-30min 30+min
Yes No
Yes No