• Client Survey

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Client Survey

Your feedback is important to us! If you are a current or past patient, we want to know about your experience. Please take a few moments to fill out our client survey. Your responses will be kept confidential and will help us serve you and others better in the future!






    Name (optional):

    How Friendly is our staff?
    With 1 being “Unfriendly” and 5 being “Very Friendly.”

    a. Front Office/Phone:
    12345
    b. Therapy Staff
    12345
    c. Billing Department:
    12345

    How would you describe the atmosphere in the clinic?

    With 1 being “Unpleasant” and 5 being “Very Pleasant.”
    12345

    How would you describe the professional conduct of our staff?

    With 1 being “Unprofessional” and 5 being “Very Professional.”
    12345

    Were we able to accommodate your needs? ie. scheduling, interpreting, questions,
    exercise assistance, proper attention, etc.

    With 1 being “Never” and 5 being “All the time.”
    12345

    How would you describe the clinic working space, equipment & supplies? ie. space
    for exercise, cleanliness, condition of equipment, etc.

    With 1 being “Inadequate” and 5 being “Very Adequate.”
    12345

    How well was your time utilized in the clinic?

    With 1 being “Wasted” and 5 being “Very Well Used.”
    12345

    Did you or are you benefiting from therapy?

    YesNo

    How did you hear about us?

    Suggestions or Comments?

    Enter Phrase
    captcha

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    Healing Hands, Elbows, Shoulders & the Cervical Spine

    7005 N. Maple Ave. #104 • Fresno, CA 93720 • (559) 325-3503