What did you think of our facilities?

Was our facility easily accessible?YesNoNeeds Improvement

Was the waiting area comfortable?YesNoNeeds Improvement

Were the treatment areas clean?YesNoNeeds Improvement

Were the washrooms sanitary?YesNoNeeds Improvement

Was our exercise equipment adequate and sanitary?YesNoNeeds Improvement

Are our hours of operation convenient for you?YesNoNeeds Improvement

Was our telephone greeting pleasant?YesNoNeeds Improvement

Were you greeted in a friendly manner?YesNoNeeds Improvement

Did the staff explain equipment procedures? YesNoNeeds Improvement

Was there anything else that the staff could have done to make you feel comfortable?

Was your injury adequately explained?YesNoNeeds Improvement

Was the physiotherapist friendly?YesNoNeeds Improvement

Did you feel comfortable asking questions?YesNoNeeds Improvement

Was your treatment effective?YesNoNeeds Improvement
If not, please explain:

Did you feel that you were:Treated too FrequentlyTreated AppropriatelyNot Frequently Enough
Other:

Overall, do you have any suggestions for improvements?

Who was your Physiotherapist?

Family PhysicianNewspaperFriend or FamilySpecialistWorkers CompRehabilitation ConsultantEmployerInsurerMagazine Rack DisplayPreviously attended West-Fit
Other: