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Physical therapy survey template

Keep patients on their plan, one session at a time

Four questions for after a physical therapy session: how patients feel leaving, how clear their home exercises are, whether they understand the plan and what they want to bring up next time. Use it as it is or change any question, and Usertick reads every written answer for you.

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What this physical therapy survey tells you

A physical therapy survey checks the part of care that happens between sessions. Patients do much of the work at home, so this template asks whether the home exercises are clear and whether the treatment plan makes sense, along with how the session left them and what they want to talk about next time. It takes under a minute.

It is written for the hour after a session, sent by Usertick email to the patients seen that day or as a link in the message your booking system sends after each visit. Print its QR code on the exercise sheet, and patients can answer from home.

Results shows the faces from worse to much better with each share, the average clarity of the exercises with the share who rated 4 or 5, and the share who understand their plan. Every written answer is read as it arrives and filed under a category such as care and treatment or booking and appointments, with a type and an urgency.

In an emailAs a linkOn your websiteAs a conversation
Questions
4
Time to answer
About a minute
Written for
The hour after a session, by email or a link from your booking system
Plans
Every plan, the free plan included

See it on every channel

The same template on your website, behind a link, in an email and as a conversation.

In an email

Send it from Usertick to a contact list, and a button in the email opens the survey on its own page. Usertick sends 50 emails a month on the free plan, or connect your own sender.

The 4 questions, one by one

What each question asks, why it is there, what it shows you and what to change.

Question 1 of 4 · Mood dial

How do you feel after today's session?

Why ask it
How patients leave the clinic shapes whether they come back for the next session. A dial of five faces from worse to much better is quick to turn and keeps the answer to a feeling about the session.
What you learn
Faces from unhappy to happy, each with its share, against the period before. Select Worse to narrow the page to those patients and read what they want to discuss next time.
Make it yours
In the email, a dial shows as a button that opens the survey; move the exercises rating first when you want patients to answer inside the message.
Question 2 of 4 · Stars

How clear are your exercises for home?

Why ask it
Home exercises only help when patients know how to do them. A 5-point rating from very unclear to very clear shows whether the sheet, the video or the demonstration got through.
What you learn
The average, a bar per rating and the share who rated 4 or 5, compared with the period before. Select the 1s and 2s to read what those patients want to discuss next time.
Make it yours
When clarity drops, change one thing, such as a printed sheet with pictures, and watch the share of 4s and 5s in the next period.
Question 3 of 4 · Yes / No

Do you understand your treatment plan?

Why ask it
A patient who doesn't understand the plan may stop coming before it ends. A No points to a conversation for the start of the next session.
What you learn
The share that said yes, against the period before. Select No to see how those patients rated the clarity of their exercises.
Make it yours
Give each No an owner in the inbox, so the therapist goes over the plan when the patient comes back.
Question 4 of 4 · Text · Optional

Is there anything you'd like to discuss next time?

Why ask it
The last question gives patients room to raise something before the next session, such as the schedule, an exercise they skipped or a question for the therapist.
What you learn
Each answer with its sentiment and theme, filterable by theme, with up to 8 themes and their trends. Usertick also marks each one as a question, an idea, a complaint or praise, and flags the urgent ones.
Make it yours
Use the placeholder to point patients to scheduling and exercises, and to keep symptoms for the session itself.

What the answers show

Results turns each question into numbers you can follow week by week.

How clear are your exercises for home?

The average rating and the share who gave 4 or 5 stars, against the period before.

Every written answer, read for you

Each answer arrives with its category, theme, type and urgency, so the urgent ones reach your team first.

Use this template in four steps

From the template to the first answers.

  1. 1

    Open the template

    Sign up free and pick Physical therapy session in the template gallery. It opens in a matching style, ready to change.

  2. 2

    Make the questions yours

    Reword any question, change the options, and add logic or more questions.

  3. 3

    Choose where it runs

    Show it on your website, send it by email, share its link and QR code, or switch it to a conversation.

  4. 4

    Publish and read the answers

    Answers arrive in Results and the inbox as people send them, each written one read and filed by Usertick.

Tips for this survey

Small choices that keep people answering and the answers useful.

  1. 01

    Ask after every session

    Skip people who already received this survey is on by default. Turn it off, so a patient on a six-week plan can be asked after each session.

  2. 02

    Send it the same day

    Send the survey to the day's patients after the last session, or put the link in the message your booking system sends. Usertick doesn't send on its own when a session ends.

  3. 03

    Read answers before the next visit

    Give each written answer an owner and a note in the inbox, so the therapist has read it before the patient arrives.

  4. 04

    Keep symptoms in the clinic

    Ask about the session, the exercises and the plan, and leave pain and diagnoses to the clinical record. Usertick's terms don't allow medical details in surveys, and Usertick doesn't sign business associate agreements.

CSAT surveysPatient satisfaction surveysEmail surveysPhysical therapy questions

More satisfaction templates and questions

Templates like this one, and single questions from the library to add to it.

Templates

Browse all templates
CSATAppointment experienceLearn how patients experienced a visit, from booking and waiting to how clearly things were explained and what happens next. Send it the same day, and keep it free of medical details.
CSATPharmacy visitLearn how customers rated a pharmacy visit, the wait and how clearly the medicine was explained. Share it on the receipt with a QR code.
CSATDental visitLearn how patients rated their dental visit, from comfort in the chair to how clearly costs were explained. Send it the same day.
CSATEmergency visitLearn how patients experienced an emergency visit: waiting, respect, pain management and discharge. Send it two days after discharge.

Questions from the library

Browse the question library
  1. How much progress have you made since your first session?Big scale · Physical therapy
  2. Do you know what to do between sessions?Yes / No · Physical therapy
  3. How often do you do your exercises at home?Multiple choice · Physical therapy
  4. How are you feeling today?Mood dial · Therapy and well-being
  5. How much progress do you feel you are making?Big scale · Therapy and well-being
  6. For sessions you preferThis or that · Therapy and well-being

Frequently asked questions

Within a few hours of the session, while the exercises are fresh. Usertick sends the email now or at a scheduled time, and the link can go in the message your booking system sends after each visit.

After each session suits a short plan, and every few sessions suits a long one. Turn off Skip people who already received this survey so the same patients can be asked again.

Few enough to answer on the way home. This template asks four and takes under a minute.

Read what they wrote in the last question and have their therapist call before the next session. The survey tracks the experience of care, so keep the conversation about symptoms in the clinic.

Yes. Print the survey's QR code on the sheet, and it opens the hosted survey page in the patient's phone browser.

Yes. Every template comes with every plan, the free plan included, and the free plan covers 150 responses a month across your surveys.

Yes. The template becomes your own survey, so reword any question, add or remove questions, and change the options and the logic. The gallery stays as it is.

Yes, from Starter. The template is written in US English. Add languages by hand or with AI translation, and each person sees the survey in their browser's language.

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