Foundations Physio Feedback Form

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* 1. What was your reason for choosing Foundations Physio?

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* 2. How long has your treatment been ongoing with Foundations Physio?

Under 6 Months

6 Months - 1 Year

1 Year - 2 Years

2 Years - 3 Years

3 Years +

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* 3. How well did your Physiotherapist listen to your needs?

Extremely well

Very well

Somewhat well

Not so well

Not at all well

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* 4. How well did your Physiotherapist explain your treatment options?

Extremely well

Very well

Somewhat well

Not so well

Not at all well

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* 5. Is there anything you feel we could improve on as a service?

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* 6. How likely is it that you would recommend this company to a friend or colleague?

NOT AT ALL LIKELY

EXTREMELY LIKELY

0

1

2

3

4

5

6

7

8

9

10

0

1

2

3

4

5

6

7

8

9

10

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* 7. How likely are you to use our service again in the future?

Extremely likely

Very likely

Somewhat likely

Not very likely

Not at all likely

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* 8. Overall, how would you rate Foundations Physio?

Excellent

Very good

Good

Fair

Poor

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* 9. If you could leave us a short testimonial on how Foundations Physio has impacted your health and well being, it would be much appreciated. We would love to hear your feedback.

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* 10. Do you consent to your feedback being published on our website and social media platforms?

Yes

No