Questionnaire – TEST

Please Answer All Questions

  • General Info
  • Question 1-4
  • Question 5-8
  • Question 9-12
  • Question 13-14

Personal Info

First Name

Last Name

Email Address

Question 1-4

1) I highly value taking care of my health and wellness. I am willing to do whatever it takes to maintain it.

2) I have been to traditional physical therapy places before, and I didn’t have an amazing experience.

3) Do you value having customized physical therapy care that will address the CAUSE of your condition or injury?

4) Taking care of my health is an investment, not an expense

Question 5-8

5) Do you value seeing an in-network provider over your quality of physical therapy when choosing a provider?

6) I am aware that in-network physical therapists can’t spend much time with me because of how many patients they see every hour.

7) I am only going to see a physical therapist because my doctor sent me. I would not consider seeing a physical therapist otherwise.

8) I am an active person and exercise regularly.

Question 9-12

9) I am a sedentary person and have no desire to live an active lifestyle.

10) I am a sedentary person, but I really want to get into shape. I do not know how, but I would like to get started!

11) Finding a physical therapy provider who is in-network is important, but getting high quality, expert care is even more important to me.

12) I really want to work with a physical therapist who will take the time to listen to me

Question 13-14

13) I want to work with a physical therapist who understands and works with active people.

14) I am frustrated that I can't do my favorite activities because of my injury or condition and would do anything to get back to these activities!

Please share any comments or additional information.