Physical Therapy Survey

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We are so pleased that you chose Nifty Physical Therapy as your physical therapy provider. We truly value you as a patient and want to exceed your expectations at EVERY visit! Please help us by completing this brief survey and providing your honest feedback. Thank you for your time.

Name of your Referring Physician:

Nifty after Fifty Location: *

My initial evaluation was scheduled within 24-48 hours or within my desired time frame:

Yes

When I arrived for my appointment the service began promptly:

Clinician introduced him/herself to me personally:

Yes

The evaluation and treatment I received was explained in a clear and helpful manner:

The aides/assistants were helpful and courteous in all aspects of my care:

I received helpful responses to my questions and concerns:

I received enough individual attention from my physical therapist:

My physical therapist communicated with my doctor regarding my therapy process:

Please rate the improvement in your condition due to physical therapy:

Paperwork and procedures were explained in a clear and helpful manner:

What is your overall impression of Nifty Physical Therapy:

What could we have done to make your visit(s) better?:

Would you refer someone to Nifty Physical Therapy?:

Yes

First and Last Name: *

Email Address:

Re-enter email:

Comment:

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Get Started today with Nifty after Fifty^®. Call (855) BE-NIFTY.

Center for Greater Wellness and Lasting Independence^®.

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12572 Valley View Street
Garden Grove, CA 92845

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