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EVANSTON CLINIC
620 W. Cheyenne Drive
Evanston, WY 82930
Phone: (307) 789-8860
Fax: (307) 789-8394

BRIDGER VALLEY CLINIC
64 Meadow Street (Urie Mall)
Urie, WY 82937
Phone: (307) 786-4460
Fax: (307) 786-4461
Download Satisfaction Survey (Word)
Satisfaction Survey
Dear Friend,
Wyoming Specialized Physical Therapy strives to deliver the best possible physical therapy services. We are interested in learning from our patients, how we might improve or enhance our services. Please take a few moments to complete and return this questionnaire.

Please select a location:
Your Gender:

How did you learn about this facility? (Check all that apply)


Please rate your degree of satisfaction with each of the following statements. Very
Satisfied
Satisfied Dissatisfied
1. Your physical therapistís understanding of your condition.
2. Explanation of your physical therapy treatment program.
3. Treatment provided by your physical therapist.
4. Your physical therapy instructions at time of discharge.
5. Respect for your privacy during physical therapy care.
6. Were your goals for coming to physical therapy met?
7. Overall, satisfaction with my experience in physical therapy.
8. Ability to make convenient appointments.
9. Contacting the physical therapy office by telephone.
10. Physical therapy office hours.
11. Length of time waiting before receiving treatment.
12. Was the office clean and in good repair?
13. Was your billing statement processed in a correct and timely manner?

I would recommend this facility to family or friends.




Thank you, for taking the time to complete this questionnaire.
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