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Feedback - Client Service Satisfaction Survey

 
 
Clinic you received treatment from: *
Your Name (Optional):
Contact Info (Optional):
 
Your feedback is very important to us. Please help us to improve by answering some questions about the services you have received. We are interested in your honest opinions, whether positive or negative. We also welcome your comments and suggestions. Thank you very much.
Please select the option that best reflects your opinion on each of the following questions:
 
1. How would you rate the quality of service you received?





2. Did you get the kind of service you wanted?





3. To what extent has our program met your needs?





4. If a friend were in need of similar help, would you recommend our program to him/her?





5. How satisfied are you with the amount of help you received?





6. Have the services you received helped you deal more effectively with your problems?





7. In an overall, general sense, how satisfied are you with the service you received?





8. If you were to seek help again, would you come back to our program?





9. How satisfied are you with the accessibility of our clinic (physical and communication)?





Comments:
 
CLINICS
Chemong Physiotherapy
Lindsay Physiotherapy Services
Lindsay Rehab Health Centre
Trent Health in Motion
Peterborough Physiotherapy
& Sports Injuries Clinic
Lakefield Physiotherapy
& Foot Health Clinic
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& Performance Evaluation
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CONTACT US
Chemong Physiotherapy
Lindsay Physiotherapy Services
Lindsay Rehab Health Centre
Trent Health in Motion
Peterborough Physiotherapy
& Sports Injuries Clinic
Lakefield Physiotherapy
& Foot Health Clinic
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