Business Office: 4251 Lahmeyer Road, Fort Wayne, IN 46815
Business Office: (260) 432-4700
Scheduling: (260) 209-2464

comments@indianapt.com

Patient Satisfaction Survey

Thank you for choosing Indiana Physical Therapy as your therapy provider. As we try to make your visit with us positive and productive, we are also open to your suggestions on how to improve our service to you.

At which location did you receive services?

Who was your therapist?

Why did you choose to have your therapy done at Indiana Physical Therapy?
 Reputation Insurance/Employer Directed by your Physician Location Advertisement (TV, print, billboard, etc) Other, please explain

Was the phone etiquette of the front desk courteous?
 Exceeded my expectations Satisfactory Less than satisfactory

Was the front desk staff friendly, helpful and professional?
 Yes, I was greeted promptly and given concise and professional help Neutral No, the office staff could have improved in all three areas

Please explain any observations that could improve your experience

How would you rate the courtesy and efficiency of our front office staff?
 They were very courteous, friendly and my check-in/out was quick and efficient They were friendly but not efficient during the check-in/out process Neutral They were efficient and prompt, but could improve friendliness while checking in/out The staff was neither friendly nor efficient

Please explain any observations that could improve your experience

Were your registration forms, benefits and IPT policies adequately explained?
 Exceeded my expectations Satisfactory Less than satisfactory

Was the appearance of the clinic and front office clean and well maintained?
 Exceeded my expectations Satisfactory Less than satisfactory

Please explain any observations that will help IPT improve in this area

Was your billing for services explained, understandable and any questions adequately answered?
 Exceeded my expectations Satisfactory Less than satisfactory

Please explain any observations that will help IPT improve in this area

Have you had physical therapy at another provider before?
 Yes No

If yes, where?

Did the IPT therapist explain in a clear and helpful manner your evaluation and treatment?
 Exceeded my expectations It was explained but I felt it was too technical and I did not understand the treatment completely No, I was not comfortable with the explanation and/or the explanation did not satisfy my questions moving forward in treatment

Please explain any observations that could improve your experience

What did you like best about your experience at Indiana Physical Therapy?

In what areas can Indiana Physical Therapy improve to make your experience better?

Overall, were you satisfied with your experience at Indiana Physical Therapy?
 Exceeded my expectations Satisfactory Neutral Somewhat dissatisfied Very dissatisfied

Please explain any observations that could improve your experience

Would you like to make any additional comments, recommendations or share a positive experience of one or more of the IPT staff during your time at Indiana Physical Therapy?
 Yes No

If yes, please use the box below to continue:

May Indiana Physical Therapy share any comments on our website and/or other marketing material in the future?
 Yes No

If yes, please use the box below to continue:

Would you like to be contacted by an IPT representative concerning your experience?
 Yes No

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