Physiotherapy patient satisfaction questionnaire template


Please take a few minutes of your time to fill in the following survey.

1. What were the circumstances and injuries requiring you to need physiotherapy?


2. What therapy types have you received?

  • Exercise of the area affected
  • Massage
  • Wirlpool bathing
  • Magnetic therapy

3. How did you arange your first appointment with us?

  • Telephone
  • In person
  • Via the internet

4. How would you rate your experience in booking your appointments with us?

5. Did you encounter a problem with your booking or appointment?

  • No

6. Were you satisfied with the services provided by our reception desk and physiotherapy centers?

  • Very satisfied
  • Satisfied
  • Neither satisfied nor dissatisfied
  • Dissatisfied
  • Very dissatisfied

7. Please rate the following statements regarding the physiotherapy you received:

Please rate the following: 1 - Excellent, 5 - Worst

  • 1
  • 2
  • 3
  • 4
  • 5

The Physiotherapist behaved professionaly at all times

  • 1
  • 2
  • 3
  • 4
  • 5

The physiotherapist was sensitive and perceptive in my treatment

  • 1
  • 2
  • 3
  • 4
  • 5

The physiotherapist kept me well informed at all times

  • 1
  • 2
  • 3
  • 4
  • 5

8. How satisfied were you with the physiotherapy you received at our center?

9. How satisfied were you with the results of your physiotherapy?

10. How do you think we can improve our services? Please tell us in your own words:


Use template — it’s free

Physiotherapy patient satisfaction survey

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Do you provide post-traumatic care? Increase the credit of your facility among patients. Use a questionnaire template of patient satisfaction with rehabilitation.

Use template — it’s free

The survey sample is ideal for

  • founders and management of rehabilitation centers,
  • managers of specialized departments.

Use references to improve services and increase the comfort of your patients during their postoperative recovery. Pay attention to such details as the employee’s attitude at the reception, the method of providing information or the registration system for individual procedures. The questionnaire of patient satisfaction with rehabilitation contains a set of pre-prepared questions, which you can adjust as needed and thus adapt the entire form to the desired intention.

The questionnaire template can be fully edited. Survio will process your answers into well-arranged tables and graphs.

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