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Patient Survey
  1. Thank you for choosing Palm Coast Physical Therapy Center as your physical therapy provider. We truly value you as a patient and would like to continue to provide outstanding service to your EVERY VISIT! You honest feedback is appreciated. Please help us to exceed your expectations by filling out this brief survey. Thank you for your time.
  2. Name Of Referring Physician
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  3. Courtesy of office personnel
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  4. Courtesy of Clinical Staff
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  5. Phone Etiquette of Font Office Staff
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  6. Clinician Introduced Himself/Herself Personally
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  7. The evaluation and treatment I received was explained in a clear and helpful manner
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  8. The aides were helpful and courteous in all aspects of my care
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  9. Helpful responses were provided for my questions and concerns
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  10. My initial evaluation was scheduled within 24-48 hours or within my desired time frame
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  11. Appointments were scheduled to my convenience
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  12. When I arrived for my appointment the service began promptly
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  13. I received enough individual attention from my therapist
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  14. My clinician communicated with my doctor regarding my therapy process
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  15. Please rate the improvement in your condition due to physical therapy
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  16.  
  1. Cleanliness of facility
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  2. Atmosphere
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  3. Equipment type and availability
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  4. Parking
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  5. Paperwork and procedures were explained in a clear and helpful manner
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  6. Handling of billing and co-pays
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  7. What is your overall impression of the Palm Coast Physical Therapy Center
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  8. Would you refer someone to the Palm Coast Physical Therapy Center?
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  9. Would you recommend that your physician refer patients to the Palm Coast Physical Therapy Center?
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  10. Can we share your comments as testimonials or with your referring physician?
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  11. What could we have done to make your visit better?
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  12. Name (first name, last name)
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  13. Email Address
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  14. Submit Survey