Sussex County Total Health

We would appreciate your feedback!. Please take a few moments to fill out the patient satisfaction survey below.

Thank you,

Patient Survey

Name:

Today's Date: mm/dd/yyyy

On a scale of 1 thru 5 with 1 being dissatisfied and 5 being extremely satisfied please answer the following questions:

Our staff was pleasant and professional

You understood the treatment plan outlined by your Physical Therapist

Your goals were achieved

Your level of discomfort has decreased

Your condition has improved greatly because of therapy

Please select YES or NO to the next 3 questions

I would return to Sussex County Physical Therapy and Rehabiliation if I needed Physical Therapy again Yes No

I would recommend Sussex County Physical Therapy and Rehabilitation to my family, friends and co-workers Yes No

May we share this survey with your Doctor? Yes No

Comments:

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