Patient Satisfaction Questionnaire We value your thoughts on our service. Please complete the questions below and leave any comments you feel are appropriate in the space provided. This information will enable us to identify things that we could do better. This will ensure patients will receive the best possible service from the Kildare/ West Wicklow Primary Care Physiotherapy Team. Was your consent sought at each treatment? Often Sometimes Never ⁭ Always ⁭ ⁭ ⁭Seldom ⁭ Did your therapist introduce themselves? strongly agree not sure Disagree strongly Disagree ⁭ ⁭Agree ⁭ ⁭ ⁭ Were you given a choice about when your appointment(s) would take place? Often Sometimes Seldom Never ⁭Almost ⁭ ⁭ ⁭ ⁭ How satisfied were you with the time you had to wait in the waiting room for your initial physiotherapy assessment? Very satisfied Satisfied neither Dissatisfied ⁭ ⁭ ⁭ ⁭ ⁭Very Dissatisfied My physiotherapist treated me with consideration, dignity and respect? Always Often Sometimes Seldom Never ⁭ ⁭ ⁭ ⁭ ⁭ My physiotherapist listened to me? Always Often Sometimes Seldom Never ⁭ ⁭ ⁭ ⁭ ⁭ Did you understand your your plan for treatment? physiotherapist’s explanation of Always Often Sometimes Seldom Never ⁭ ⁭ ⁭ ⁭ ⁭ Did you feel involved in decisions about your treatment? Always Often Sometimes Seldom Never ⁭ ⁭ ⁭ ⁭ ⁭
Patient Satisfaction Questionnaire We value your thoughts on our service. Please complete the questions below and leave any comments you feel are appropriate in the space provided. This information will enable us to identify things that we could do better. This will ensure patients will receive the best possible service from the Kildare/ West Wicklow Primary Care Physiotherapy Team. Was your consent sought at each treatment? ⁭ Always ⁭ Often ⁭ Sometimes ⁭Seldom ⁭ Never Did your therapist introduce themselves? ⁭ strongly agree ⁭Agree ⁭ not sure ⁭ Disagree ⁭ strongly Disagree Were you given a choice about when your appointment(s) would take place? ⁭Almost ⁭ Often ⁭ Sometimes ⁭ Seldom ⁭ Never How satisfied were you with the time you had to wait in the waiting room for your initial physiotherapy assessment? ⁭ Very satisfied ⁭ Satisfied ⁭ neither ⁭ Dissatisfied ⁭Very Dissatisfied My physiotherapist treated me with consideration, dignity and respect? ⁭ Always ⁭ Often ⁭ Sometimes ⁭ Seldom ⁭ Never My physiotherapist listened to me? ⁭ Always ⁭ Often ⁭ Sometimes ⁭ Seldom ⁭ Never Did you understand your physiotherapist’s explanation of your plan for treatment? ⁭ Always ⁭ Often ⁭ Sometimes ⁭ Seldom ⁭ Never Did you feel involved in decisions about your treatment? ⁭ Always ⁭ Often ⁭ Sometimes ⁭ Seldom ⁭ Never
physiotherapy-service-evaluation-example-8.docx