Post-Care Survey

Pritchette Physical Therapy constantly strives to provide the highest quality physical therapy care and are always looking for ways to improve.  Your feedback is important to us.  Please take some time to fill out the form below.  Feel free to include your name or exclude it if you prefer to remain anonymous.  Thank you!


Name (Optional)
Name (Optional)
Why were you referred to physical therapy (chief complaint or diagnosis)?
Benefit Explanation *
Were your insurance benefits explained to you on or before your first visit?
Wait Time *
About how long did you have to wait to see your therapist after you arrived for your scheduled visit?
Satisfaction of Care *
How satisfied were you with the care provided by your physical therapist?
Care/Treatment Effectiveness *
After receiving care, do you feel your complaint/problem:
Would you consider using our services in the future? *
Have you any specific sucesses as a result of your treatment that you would like to share?
May we share your responses? (We will not share your personal information) *