BaySport Physical Therapy Report Card

BaySport is committed to providing only the highest quality of physical therapy service. As part of our ongoing quality assurance program we are very interested in hearing about your experience with BaySport. Your responses are confidential and will be used to help improve our services. Please take a moment to complete our report card.

Please check the box that best describes your experience.	Excellent	Good	Needs to improve	Unsatisfactory
1. Convenient location and appointment availability.
2. Promptness in starting therapy sessions.
3. Facility appearance and cleaniness.
4. Understandable billing statements.
5. Knowledgeable therapist - understood injury and how to treat it.
6. Professionalism by BaySport team members.

7. Therapist developed goals for my therapy.	Yes	No
8. I was given a home program with clear instructions.	Yes	No
9. I will return to this facility if I require physical therapy care in the future.	Yes	No
10. I will recommend BaySport Physical Therapy services to others.	Yes	No

What did you like best about physical therapy at BaySport?


What can we do to improve your overall experience?

Patient Name (optional):
Primary Therapist Name:		Referring Physician's Name:
My BaySport Location:	Santa Clara Redwood City Los Gatos San Diego