Outpatient Satisfaction Survey | Baton Rouge Rehabilitation Hospital

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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::
(required)

Outpatient Therapy

Day Treatment

1. The admissions/scheduling staff members were courteous and respectful:
(required)

Never

Sometimes

Usually

Always

2. The admissions process was efficient and appropriate:
(required)

Never

Sometimes

Usually

Always

3. My therapist was prompt for my scheduled visit time:
(required)

Never

Sometimes

Usually

Always

4. My therapist was courteous and respectful:
(required)

Never

Sometimes

Usually

Always

5. My therapist understood my condition and goals:
(required)

Never

Sometimes

Usually

Always

6. My therapist listened to my concerns:
(required)

Never

Sometimes

Usually

Always

7. My therapist explained my treatments in a way I could understand:
(required)

Never

Sometimes

Usually

Always

8. My therapist gave me instructions/home program that was helpful:
(required)

Never

Sometimes

Usually

Always

9. Overall, I was satisfied with the quality of my therapy:
(required)

Yes

10. I would return to Baton Rouge Rehab Hospital for therapy in the future:
(required)

Yes

If you did not answer yes, why?:

11. I would recommend Baton Rouge Rehab Hospital to my family and friends:
(required)

Yes

If you did not answer yes, why? :

Additional Comments:

Your Name (Optional):

E-Mail Address (Optional):

Date:
(required)

Reason for Therapy Referral:
(required)

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