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Discharge Survey 2015

Discharge Survey
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Thank you for being a client of Conifer Physical Therapy.  In an effort to serve you better, we would like to ask you a few questions about your experience with our clinic.
Your participation in this Discharge Survey is completely voluntary.  It is very important for us to learn your opinions.

Your survey responses will be strictly confidential.  If you have questions at any time about the survey , you may contact Paige at (303)838-7444 or by email at
[email protected].

Thank you very much for your time and support. Please start the survey now by clicking on the Continue button below.
 
 
 
How did you hear about us?
 
Website
 
Mailer
 
Doctor
 
Friend / Family
 
Other
 
 
 
 
Who was your physical therapist?
 
Dana Amundson, PT, DPT
 
Mary Thuente, PT, MSPT
 
Tiffany Wolf, PT, DPT
 
 
 
Ease of scheduling appointments?
 
Outstanding
 
Okay
 
Needs Work:
 
 
 
 
How was your experience with the Front Desk?
 
Outstanding
 
Okay
 
Needs Work:
 
 
 
 
How was your experience with your Therapist?
 
Outstanding
 
Okay
 
Needs Work:
 
 
 
 
Was your billing handled appropriately?
 
No Problems
 
Had some problems but resolved
 
Had some problems - not resolved
 
Other
 
 
 
 
Yes No
Would you return in the future if the need arises?
Would you recommend us to other?
 
 
 
*Optional - Your Name:
   
 
 
 
Any additional comments and/or Suggestions:
   
 
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