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Bethel Health Care Outpatient Rehabilitation & Wellness Center Patient Satisfaction Survey



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Thank you for choosing Bethel Health Care Outpatient Rehabilitation. We hope we were able to meet your rehabilitative needs. To better serve our patients, we ask that you take a moment to complete this Patient Satisfaction Survey. Your feedback is very important to us. The input you provide will go to our Rehabilitation Director and will be integrated into our Total Quality Improvement Process.
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1.  
Your name
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2.  
Today's Date
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3.  
Survey completed by
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4.  
Referred to Bethel Health Care Outpatient Therapy by:
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5.  
Bethel Health Care Outpatient Therapy was recommended by:
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6.  
My therapist was:
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7.  
  1. The therapy staff approach to your treatment was:
Compassionate

Respectful

Courteous

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8.  
The therapy staff kept you well informed of your treatment and progress
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9.  
The therapy staff provided you with clear instructions and a home exercise program
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10.  
The therapy staff involved you in decisions that affected your care and goals
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11.  
The therapy staff started treatment at your scheduled appointment time
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12.  
I would recommend my therapist to a friend
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13.  
I would return to BHC outpatient therapy if I needed services in the future
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14.  
Appointment times available were convenient
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15.  
My rehabilitation goals were met (e.g. pain managed, function improved)
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16.  
Space & equipment were appropriate to address my therapeutic needs and maintain my privacy
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17.  
Please add any additional comments or suggestions that might improve our services in the future.
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18.  
Contact Information
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19.  
Best time to reach me:
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20.  
Phone Number:

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