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Survey - Chautauqua Physical & Occupational Therapy
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What percent improvement did you experience with treatment?
Select a Value
76-100%
51-75%
25-50%
No Better
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How soon were you able to make your first appointment?
Select a Value
Same Day
Within 2 days
Within 1 week
Within 2 weeks
Very
Good
Good
Average
Below
Average
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The courtesy you experienced with our front office staff was?
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Ease of scheduling?
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The courtesy of our clinical staff was?
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Explanation of your problem and how your therapist planned to help you?
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Respect for my confidentiality/privacy?
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Cleanliness?
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Overall Quality of Care and Service?
What did we do well with your care?
What could we have done better?
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At which location did you receive treatment?
Select a Value
Jamestown
Mayville
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Would you use us again?
Yes
No
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Would you recommend us to a friend?
Yes
No
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I give my permission to use my comments
Yes
No
Name (Optional)
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