623 Highway 71 West, Suite 100
Bastrop, TX 78602
Phone (512) 321-9659
Fax (512) 321-1226
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Patient Survey
Tim Garner
We appreciate the opportunity to participate in your care. Please take a few minutes to help us improve our services by filling out this survey.
Name (not required):
*
What service did you receive at Garner & Riley Physical Therapy?
*
Physical Therapy
Aquatic Therapy
Fitness
How did you hear about Garner & Riley Physical Therapy?
*
Internet Search
Advertisement
Friend
Doctor
Other
If Other please specify:
*
Why did you choose Garner & Riley Physical Therapy for your PT?
*
Recommendation from Doctor
Recommendation from Friend
Location
Previous experience with Garner & Riley
I chose you because of your fabulous website!
Other
If Other, please specify:
*
What body region was treated at Garner & Riley Physical Therapy?
*
Back/Neck
Shoulder
Elbow/Wrist/Hand
Hip/Knee
Ankle/Foot
Neurologic Diagnosis
What is your age?
*
Less than 13
13-18
19-25
26-35
36-50
50-64
65 and up
Prefer not to say
Were you satisfied with the friendliness of the front office staff?
*
Extremely satisfied
Mostly satisfied
Neutral
Mostly dissatisfied
Extremely dissatisfled
Were you satisfied with the registration process?
*
Extremely satisfied
Mostly satisfied
Neutral
Mostly dissatisfied
Extremely dissatisfied
The waiting area was clean and comfortable.
*
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
My therapist spent enough time with me.
*
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
My therapist treated me respectfully.
*
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
My therapist advised me on ways to avoid future problems.
*
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Were you satisfied with the care you received at Garner & Riley Physical Therapy?
*
Extremely satisfied
Mostly satisfied
Neutral
Mostly dissatisfied
Extremely dissatisfied
*
Indicates required field
Will you return to Garner & Riley for future physical therapy needs if they arise?
*
Yes
No
Maybe
What can we do to improve our business?
*
Submit survey
