Online Patient Feedback

Patient Name (Optional)

Patient Email
Was this your first visit to Sandalwood Physio?
YesNo
What service(s) have you received? (Please check all that apply)
PhysiotherapyMassage TherapyChiropractic CareAcupunctureMotor Vehicle Accident (MVA) RehabilitationWork Place Injury (WSIB) Rehabilitation

Who was your therapist/doctor?

Please rate your level of satisfaction with our performance in the following (1=Strongly Agree, 5=Strongly Disagree):

Receptionist was courteous and professional?
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Treatment goals were explained?
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Therapist/Doctor was knowledgeable about my condition?
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Therapist/Doctor was courteous and professional?
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Therapist/Doctor was helpful during my treatment?
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Therapist/Doctor took the time to answer my questions?
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Overall I am satisfied with the treatment I have received?
12345
Would you recommend us to a friend or family member?
YesNo

Do you believe that you are well informed about our services and products?
YesNo

What would you like to see improved at Sandalwood?

What do you like most about Sandalwood Physio?

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