Sport & Spine - Patient Survey

Bridgeport Midland Saginaw Shields

PATIENT SURVEY

Sport & Spine is always striving to improve the customer service, care, and entire experience of each client. Please take a few moments of your time to complete the short survey below. Your comments will help us evaluate our operations to ensure we are truly responsive to your needs. Thank you.

Please answer the following questions as honestly as possible.
	N/A = No Answer
1.	At which clinic did you receive care?
2.	How did you first hear about Sport & Spine?
3.	Were you informed of the first-time patient forms on the website that could be completed in advance.	Yes No N/A
4.	Upon arriving at the clinic, I was greeted by a friendly staff.	Yes No N/A
5.	The clinic’s billing and payment policies were explained to me in terms that I understood.	Yes No N/A
6.	If known, please select the name of your therapist:

On a scale of 0-5, please rate questions 7-10:		Scale
	0 = No Answer, 1 = Lowest/Worst, 5 = Highest/Best	0	1	2	3	4	5
7.	My therapist took the time to answer and explain all questions regarding my treatment.
8.	My therapist was attentive.
9.	The treatment I received has improved my condition/injury.
10.	I had a positive overall experience at Sport & Spine:
11.	Please share any comments, concerns, or experiences in the space provided below: