Patient Survey

At Northern Physical Therapy & Fitness, we are constantly focusing on ways to improve our service to our patients and referring physicians. Please take a moment to let us know how well we are doing and what we can do to improve our services to you by completing this short survey.

Please rate the survey questions below based on the following scale.
N/A = Not Applicable   1 = Unsatisfactory   2 = Fair   3 = Average   4 = Good   5 = Excellent

  1. Prompt and helpful scheduling of your initial appointment
    N/A12345
  2. Courtesy of office staff on the phone
    N/A12345
  3. Courtesy of office staff in the office
    N/A12345
  4. Clear understanding of fees prior to treatment
    N/A12345
  5. Promptness of Therapist's services
    N/A12345
  6. Cleanliness and pleasantness of Northern Physical Therapy & Fitness office
    N/A12345
  7. Therapist's understanding of your condition
    N/A12345
  8. Therapist's Listening Skills
    N/A12345
  9. Clear understanding of goals and treatment plan by you and your therapist
    N/A12345
  10. Helpfulness of your treatment
    N/A12345
  11. Helpfulness of staff with billing questions
    N/A12345
  12. Rate your general state of health and functioning prior to treatment
    N/A12345
  13. Rate your general state of health and functioning after your treatment was completed
    N/A12345
  14. Your likelihood of using Northern Physical Therapy & Fitness again if needed
    N/A12345
  15. Please explain your answer

  16. Your likelihood of recommending Northern Physical Therapy & Fitness to your Friends and Family
    N/A12345
  17. Please explain your answer

Make an Appointment
Patient Forms

Expedite your check-in! Print and fill out the relevant forms, and bring them with you when you arrive for your first appointment. Your already-short wait time will be reduced even further!