Website: www.ennisphsioclinic.ie

info@ennisphysioclinic.ie

Mon - Fri    9.30am - 8.30pm

3A Barrack Close, Barrack St., Ennis, Co. Clare  V95 X437

065 6840757

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Ennis Physiotherapy Clinic Feedback Form

Please provide us with some feedback about your experience at the Clinic

This helps us to maintain the highest standard of care

Please select from the drop down menu after each statement the option that most closely reflects your opinion

4/12  Behaved Professionally at all times

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

5/12  Explained  tests + treatments used

Strongly Agree

Agree

Don't Know

Disagree

Strongly disagree

6/12  Listened to what I had to say

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

The Physiotherapist….

7/12  Was easy to book my appointment

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

8/12  Was provided on time

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

9/12  Was dignified  and respectful

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

The Physiotherapy Session….

10/12  I was improved  overall

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

11/12  My expectations were met

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

12/12  My needs were addressed

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

Rate Your Physiotherapy Overall

I would recommend this practice to others

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

Satisfaction with Overall  Service

1/12  There was sufficient privacy during my visit

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

2/12  There was sufficient privacy during my visit

Strongly Agree

Agree

Not Sure

Disagree

Strongly Disagree

3/12  The clinic was clean and tidy

Strongly Agree

Agree

Don't Know

Disagree

Strongly Disagree

The Facility + Environment