Functional Performance Center

Physical Therapy & Sports Therapy Experts Tempe AZ

Patient Survey

Take our patient survey and receive a $5 Gift Card.

We feel your input is very important in providing great services and to know how we are doing!  If you would rather, you can go to our website to fill out the survey.  Please rate the following questions based on your experience at The Functional Performance Center:

1=Very Poor, 2= Poor, 3= Average, 4=Good, 5= Awesome

Name (required)

Therapist

Email

1- How is your overall experience when scheduling your appointments?

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2- How was your question(s) or concern(s) handled by the front office staff?

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3- Has the front office staff been professional and courteous towards you?

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4- Were your insurance benefits/financial responsibility explained clearly to you?

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5- How do you feel the clinical staff (therapists, assistants) addressed your primary physical therapy needs?

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6- Did you receive an appropriate and clear Home Exercise Program?

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7- If you have received physical therapy elsewhere, how does your treatment here compare?

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8- How do you feel your overall experience has been with your primary physical therapist?

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9- How was your overall experience with the staff at the Functional Performance Center?

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10- Did you receive ASTYM during your treatment? YESNO
If yes, how satisfied were you?
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11- Do you feel you are able to return to work/sport/daily activities? YESNO
If no, why?

12- Did the therapists address all your concerns?

YESNO

13- Would you return to FPC if you needed physical therapy in the future?

YESNO

14- If you appreciate the treatment you have received at FPC, we would love to include your review on our website!

15- Comments and Suggestions

(480) 968-2020

2065 S. Cottonwood Dr, Suite 1, Tempe, Arizona 85282