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document.write("Long Pond Physical Therapy \n");
document.write("110 Long Pond Road. Suite 111 \n");
document.write("Plymouth MA. 02364 \n");
document.write("ph (508)-746-6922 * fax(508) 746-7211 We are pleased that you chose our facility for you physical therapy treatment. It is important for us to know how you feelabout our office so that we can continue to improve our services to you and to others. We would appreciate a few moments of your time in completing this questionnaire. Thank you in advance-Long Pond Physical Therapy. |
| *1. How did you choose our practice? (check all that apply) | \n");
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document.write("| 2. For each question below, please indicate the answer that best represents your feelings. |
Clinic and Facility |
| Location | \n");
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document.write("| Condition and cleanliness of the clinic | \n");
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document.write("| Waiting room was clean and comfortable | \n");
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document.write("| Furnishings and décor | \n");
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document.write("| Overall appeal | \n");
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document.write("Support Staff |
| Friendly and courteous | \n");
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document.write("| Timely attention to your scheduling needs | \n");
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document.write("| Answered any insurance questions | \n");
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document.write("| Answered any billing questions | \n");
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document.write("| Returned phone calls promptly | \n");
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document.write("Clinical Staff |
| I was seen within 10 minutes of my appointment time | \n");
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document.write("| Friendly and courteous | \n");
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document.write("| My treatment plan was explained to me | \n");
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document.write("| Goals for my treatment were established | \n");
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document.write("| Communication regarding my injury or condition | \n");
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document.write("| I was satisfied how the treatments were performed | \n");
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document.write("| Communication regarding a home exercise program | \n");
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document.write("| Satisfaction with clinical staff | \n");
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document.write("General Questions |
| I have discussed this clinic with my physician | \n");
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document.write("| I would recommend this clinic to others | \n");
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document.write("| If needed, I would return to this clinic | \n");
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document.write("| Progress was made toward treatment goals | \n");
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document.write("| Does our clinic offer sufficient hours? | \n");
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document.write("| I have continued my home exercise program | \n");
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document.write("What suggestions do you have that would help us improve our clinic? What did you like best about our clinic? |
| Suggestions | |
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