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Patient Satisfaction Survey

Thank you for choosing Synergy Manual Physical Therapy. Your complete satisfaction is important to us. Please take a moment to complete this brief survey. We appreciate your feedback. All feedback received will be kept strictly confidential and used to ensure total satisfaction on future visits.


Strongly Disagree ————— Strongly Agree

Treatment (Therapist)

Strongly Disagree ————— Strongly Agree

Support Staff (Aide/Exercise Tech)

Strongly Disagree ————— Strongly Agree


Strongly Disagree ————— Strongly Agree


Please complete the following overall questions
  • When were you last treated?


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