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Patient Satisfaction Survey

Patient Satisfaction Survey

We very much appreciate your business and would love if you gave us some feedback on you experience here!
Your feedback will be kept strictly confidential, with only the clinic manager's access.
Your therapist only be informed of your feedback if you wish.

Name*
First Last
Email
What were the circumstances and/or injuries requiring you to visit our centre?*
How did you arrange your appointment with us?*
- Telephone
- Email
- In Person
- Online Booking Portal
- Other
Describe
How would you rate your experience in booking your appointments with us?*
ExcellentPretty goodNeutralNot so greatTerrible
Did you encounter a problem with your booking or appointment?*
- Yes
- No
Describe
Were you satisfied with the services provided by our reception desk*
Very Dissatisfied Dissatisfied Neutral Satisfied Very satisfied
What therapy type have you received?*
- Physiotherapy
- Massage Therapy
- Chiropody
- Traditional Chinese Medicine Acupuncture
- Yoga Therapy
Did you attend in person or virtually?*
- In Person
- Virtually
Did you find the treatment areas clean and tidy?*
- Yes
- To Some Degree
- No
Did you feel your virtual appointment was easy to access?*
- Yes
- No
Please rate the following statements regarding the physiotherapy you received.
Which Physiotherapist did you see?*
- Kristina Todorova
- Nada Masoud
- Timothy Childs
The Physiotherapist behaved professionaly at all times*
1 - Worst 2 3 4 5 - Excellent
The physiotherapist was sensitive and perceptive in my treatment*
1 - Worst 2 3 4 5 - Excellent
The physiotherapist kept me well informed at all times*
1 - Worst 2 3 4 5 - Excellent
How satisfied were you with the physiotherapy you received at our centre?*
ExcellentPretty goodNeutralNot so greatTerrible
Please rate the following statements regarding the massage therapy you received.
Which Massage Therapist did you see?*
- Josephine Ong
- Wojciech Sikora
- Jason Li
The massage therapist behaved professionally at all times*
1 - Worst 2 3 4 5 - Excellent
The massage therapist was sensitive and perceptive in my treatment*
1 - Worst 2 3 4 5 - Excellent
The massage therapist kept me well informed at all times*
1 - Worst 2 3 4 5 - Excellent
How satisfied were you with the massage therapy you received at our centre?*
ExcellentPretty goodNeutralNot so greatTerrible
Please rate the following statements regarding the chiropody treatment you received.
Which Chiropodist did you see?*
- Arien Sirois
- Nasim Rezania
The chiropodist behaved professionally at all times*
1 - Worst 2 3 4 5 - Excellent
The chiropodist was sensitive and perceptive in my treatment*
1 - Worst 2 3 4 5 - Excellent
The chiropodist kept me well informed at all times*
1 - Worst 2 3 4 5 - Excellent
How satisfied were you with the chiropody treatment you received at our centre?*
ExcellentPretty goodNeutralNot so greatTerrible
Please rate the following statements regarding the traditional Chinese medicine acupuncture treatment you received.
Josephine behaved professionally at all times*
1 - Worst 2 3 4 5 - Excellent
Josephine was sensitive and perceptive in my treatment*
1 - Worst 2 3 4 5 - Excellent
Josephine kept me well informed at all times*
1 - Worst 2 3 4 5 - Excellent
How satisfied were you with the traditional Chinese medicine acupuncture treatment you received from Josephine at our centre?*
ExcellentPretty goodNeutralNot so greatTerrible
Please rate the following statements regarding the yoga therapy treatment you received.
Ashley behaved professionally at all times*
1 - Worst 2 3 4 5 - Excellent
Ashley was sensitive and perceptive in my treatment*
1 - Worst 2 3 4 5 - Excellent
Ashley kept me well informed at all times*
1 - Worst 2 3 4 5 - Excellent
How satisfied were you with the yoga therapy treatment you received from Ashley at our centre?*
ExcellentPretty goodNeutralNot so greatTerrible
Would you like this feedback relayed to your therapist?*
- Yes
- No
How do you think we can improve our services? Please tell us in your own words:

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