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* 1. What location did you receive therapy?

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* 2. The administrative (front desk) staff was professional, courteous, and friendly.

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* 3. The therapist was on time for my appointments 

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* 4. The clinic was clean, organized, and comfortable. 

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* 5. The therapist helped me understand my injury or condition. 

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* 6. The therapist provided me with a home exercise program to allow me to continue to progress on my own.

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* 7. To what degree did the rehab you received improve your condition?

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* 8. I would recommend UP Rehab services to friends and family. 

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* 9. If you require therapy in the future, how likely are you to use our services? 

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* 10. Which factors influenced you to choose UP Rehab? (Please check all that apply) 

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* 11. May we contact you regarding your feedback?

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* 12. Do we have your permission to send you helpful information relating to optimal health and therapy? 

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* 13. To help us serve you better, please use the space below to provide additional feedback. 

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