Lakeview Subacute Care Center
Outpatient Rehabilitation Services

Patient Satisfaction Survey

          
Name: (optional)
Date:
xx/xx/xxxx
Please check the services which you recieved:

Physical Therapy      Occupational Therapy      Speech Therapy

 

  
1. All Staff was pleasant and courteous.
Always      Most of the time      Rarely      Never
2. Appointments were scheduled to accommodate my needs.
Always      Most of the time      Rarely      Never
3. My evaluation was completed promptly.
Yes      No
4. I assisted in developing my goals for therapy.
Yes      No
5. My treatment program was effective for my needs.
Always      Most of the time      Rarely      Never
6. The therapy staff was professional and skilled at their job.
Always      Most of the time      Rarely      Never
7. Problems or concerns were addressed promptly and effectively.
Always      Most of the time      Rarely      Never
8. Discharge from therapy was discussed with adequate preparation and notice.      
Yes      No
9. I would recommend Lakeview's Outpatient Services to others.
Yes      No
 
Please answer the following questions if you utilized Lakeview's bus transport to Outpatient Therapy:  
10. The bus driver was courteous and accommodating to my needs.          
Always      Most of the time      Rarely      Never          
11. The bus was able to accommodate my preferred therapy schedule.  
Always      Most of the time      Rarely      Never
12. The bus was on schedule for my pick-up and return home.    
Always      Most of the time      Rarely      Never    
Overall rating of Lakeview's Outpatient services:    
Excellent      Good      Fair      Poor    
Additional comments/recommendations to improve our program: