This survey is now closed

Physiotherapy Service Patient Questionnaire

Because part of the survey is about the Practitioner you saw today, please write the Physiotherapist's name below

In the past 12 months, how many times have you seen a Physiotherapist?

 
 
 
 
 

How do you rate the way you were treated on arrival at the clinic?

 
 
 
 
 
 

Was the appointment time convenient for you?

 
 

If no, what would be your preferred appointment day and time?

How long do you usually have to wait at the Physiotherapy Clinic for your session to begin?

 
 
 
 
 

How do you rate this?

 
 
 
 
 
 

Thinking about your treatment today, how thoroughly did the Physiotherapist ask about your symptoms and how you are feeling?

 
 
 
 
 
 
 

Thinking about your treatment today, how well did the Physiotherapist listen to what you had to say?

 
 
 
 
 
 
 

Thinking about your treatment today, how well did the Physiotherapist put you at ease?

 
 
 
 
 
 
 

After seeing the Physiotherapist today do you feel able to understand your problem(s)?

 
 
 
 

After seeing the Physiotherapist today do you feel able to cope with your problem(s)?

 
 
 
 

After seeing the Physiotherapist today do you feel able to keep yourself healthy?

 
 
 
 

Were you given any handouts / written information?

 
 

If you were given information how useful is it?

 
 
 
 
 

How likely is it that you would recommend this service to friends or family?

 
 
 
 
 

Finally, it will help us if you could tell us a little about yourself. Are you :

 
 

How old are you?

Which ethnic group do you belong to?

 
 
 
 
 
 

Which of the following best describes you?

 
 
 
 
 
 
 

We are interested in any other comments you may have. Is there anything particularly good about the care you have received at the clinic?

Is there anything that could be improved?

Any other comments?

This survey is now closed