Customer Satisfaction Survey - Performax Physical Therapy
We want to know!
To better serve you, we would like to know your opinion of the quality of our services. Please either print this customer survey off and either fax or mail to us, or fill out the online form on this page.

Please indicate the extent to which you agree or disagree with the following statements regarding the service you received at Performax.  Click the appropriate number using the scale below.
  1. I strongly disagree with the statement-(SD)
  2. I disagree with the statement-(D)
  3. I neither agree nor disagree with this statement (N)
  4. I agree with this statement (A)
  5. I strongly agree with this statement (SA)
SD
D
N
A
SA
Your first impression of Performax was a pleasant one.
Appointment times were convenient for me.
I received treatment promptly upon my arrival.
The facilities fit my needs.
The insurance process and approval process was convenient.
The treatment staff was knowledgeable, professional, and personable.
I was completely satisfied with the treatment received.
I was completely satisfied with the education and information regarding my therapy.
I would happily return for treatment of a new diagnosis.
I would recommend Performax to anyone needing therapy.
Please check the location at which you were treated.
Monroe
Flat Rock
Livonia
Woodhaven

Who significantly contributed to your care and treatment at Performax?
Please Specify:
Comments:

Did you complete your scheduled visit?
Yes
No

If you answered no above, please select the reason.
Dr. Recommended
Improved more quickly
Illness
Other (below)

How would you like to see us improve?

How did you hear about us?

Your Name (optional)

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