Omega Rehab & Physical Therapy Patient Satisfaction Form Please take a moment to complete this survey regarding your experiences during your physical therapy treatment. Thank you. How would you rate your physical therapy experience with Omega Rehabilitation Services? (Required) ---ExcellentGoodFairPoor Email (Required): Your Name: Which office did you visit?: ---Rochester HIllsMacombHazel Park Please rate the following (scale of A to E, with A being best) Were the Omega staff polite and helpful on the phone? ---ABCDE Did we schedule your therapy in a timely mannor? ---ABCDE Were the Omega staff professional during every area of your visit? ---ABCDE Were all your questions addressed thoroughly and to your satisfaction? ---ABCDE How would you rate the attentiveness of your physical therapist? ---ABCDE How would you rate your overall experience with Omega Rehabilitation? ---ABCDE Would you refer Omega Rehabilitation to family and friends? ---YESNO If no, would you allow us to contact you and ask why, so we can improve our service? ---YESNO What did you like about Omega's physical therapy services? What could we change to make our physical therapy service better? We would love to have your physical therapy testimonial. Please write a short testimonial if you have the time. - Please enter the code: