Page 1 of 1
Healthcare Survey by Oregon Exercise Therapy
Q.1
The last time you experienced musculoskeletal pain that you sought help for, who did you visit first?
*
sports medicine doctor
physical therapist
osteopath
acupuncturist
general practitioner (doctor)
postural alignment specialist (Egoscue)
pain management specialist (doctor)
massage therapist
chiropractor
Other:
Q.2
How would you rate your overall satisfaction with your visit?
*
Very satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Very dissatisfied
Q.3
Have you referred others to this practitioner/clinic?
*
Yes, only once
Yes, multiple times
No
No, but plan to in the future
What is the name of this practitioner/clinic?
Q.4
What kind of treatment/advice were you given?
*
pain medication or other pharmaceuticals (oral/topical)
ultrasound or electrical stimulation
surgery
injections (epidural, steroid, nerve block, Botox, etc)
RICE (rest, ice, compression, elevation)
exercises or stretches
manual treatment (massage, mobilization, manipulation, etc)
acupuncture
Kinesio tape, bracing, splinting, orthotics
Other:
Q.5
What was the most effective treatment you received?
*
pain medication or other pharmaceuticals (oral/topical)
acupuncture
manual treatment (massage, mobilization, manipulation, etc)
injections (epidural, steroid, nerve block, Botox, etc)
ultrasound or electrical stimulation
RICE (rest, ice, compression, elevation)
surgery
Kinesio tape, bracing, splinting, orthotics
exercises or stretches
Why did you feel this helped you the most?
Q.6
How would you rate the effectiveness of your treatments?
*
Very effective
Somewhat effective
Neutral
Somewhat ineffective
Very ineffective
Q.7
If you sought out additional help, who did you visit?
*
sports medicine doctor
massage therapist
pain management specialist (doctor)
physical therapist
acupuncturist
osteopath
chiropractor
general practitioner (doctor)
postural alignment specialist (Egoscue)
Other:
Q.8
Have you done Postural Alignment Therapy/Egoscue?
*
Yes (clinic/Skype/email)
Yes (book/website/youtube)
No
Q.9
How would you rate the effectiveness of Postural Alignment Therapy/Egoscue?
*
Very effective
Somewhat effective
Neutral
Somewhat ineffective
Very ineffective
Have not done Postural Alignment Therapy/Egoscue
Q.10
Have you referred others to Oregon Exercise Therapy/Matt Whitehead?
*
Yes, only once
Yes, multiple times
No
No, but plan to in the future
Page 1 of 1