Outpatient Satisfaction Survey
At Baton Rouge Rehab Hospital we strive to provide you with the best therapy services. To assist us in improving our services, please respond to the following questionnaire. Your information will be kept confidential. Thank you for taking the time to complete this survey. Thank you for choosing Baton Rouge Rehab Hospital.
Program
*
Outpatient
Day Treatment
*
Rows
Always
Usually
Sometimes
Never
The admissions/scheduling staff members were courteous and respectful.
The admissions process was efficient and appropriate.
My therapist was prompt for my scheduled visit time.
My therapist was courteous and respectful.
My therapist understood my condition and goals.
My therapist listened to my concerns.
My therapist explained my treatments in a way I could understand.
My therapist gave me instructions/home program that was helpful.
Overall Satisfaction
*
Rows
Yes
No
Overall, I was satisfied with the quality of my therapy.
I would return to Baton Rouge Rehab Hospital for therapy in the future.
I would recommend Baton Rouge Rehab Hospital to my family and friends.
If your answer was "no" to any of the three questions above, please explain why:
Additional Comments
Personal Information
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Reason for Therapy Referral:
May we use your comments for advertising/marketing purposes? (i.e. newsletters, social media? (No name or other identifying information will be shared)
*
Yes
No
Signature
*
Submit
Should be Empty: