Name:
Company:
Do you feel the therapist is knowledgeable in his or her field?
Select One >
5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Do you feel the therapist is polite and respectful toward you and other employees?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
How well does the IHMS Staff listen to you or your employees’ needs and concerns?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
How well does the staff member help you or your employees to understand the aches, pains or questions during the service scheduled?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Please rate the availability of hours to have your service performed.
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Do you feel the therapist takes time so not to rush thru the appointment, meeting or class?
Select One >
5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Do you feel IHMS staff is available through phone, email or to be seen at our clinic?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Was the exam area and equipment neat and clean?
Select One >
5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Should an issue arise, are we able to solve the issue quickly, how helpful is the therapist?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Does IHMS staff treat you with the utmost privacy and respect?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
How do you feel about your understanding of all the services we provide and how they will impact your company, and provide savings?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Would you recommend IHMS to other companies, family, and friends?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
How would you rate communication with your primary therapist on-site?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
When you have called our office is the person who answers the phone friendly and polite?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Are your questions answered? Do we return your phone calls promptly?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
If you are calling to schedule a service, are we able to give you a date and time?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Were reports, summaries, or feedback from on-site visits received within a timely manner?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
How well did the information you receive in those reports meet your needs and expectations?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
How well do you feel that IHMS follows through on outlined plans, schedules and yearly goals?
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5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Overall please rate your experience with IHMS.
Select One >
5-Excellent
4-Good
3-Average
2-Below Average
1-Poor
Would you be willing to provide us with a testimonial? Any specific information that you could provide on how IHMS has impacted your company (i.e. cost savings, decreased numbers of recordable, decrease in Workers Compensation premiums) would be greatly appreciated
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