First Contact Physiotherapy Feedback Form

First Contact Physiotherapy Feedback Form

  • First Contact Physiotherapy Feedback Form

    To begin, please let us know who you saw.

    Which First Contact Physiotherapist did you consult with?

  • First Contact Physiotherapy Feedback Form

    The First Contact Physiotherapist (FCP) would be grateful if you would complete this questionnaire about your visit today. The FCP you have seen is a fully qualified practitioner who had further training to work in this role in general practice/primary care. Feedback from this survey will enable them to identify areas that may need improvement. Your opinions are therefore very valuable. Please answer all the questions below. There are no right or wrong answers and your FCP will not be able to identify your individual responses. Please rate the First Contact Physiotherapist at:

    Making you feel at ease (being friendly and warm towards you, treating you with respect, not cold or abrupt).
    Letting you tell “your” story... (giving you time to fully describe your illness in your own words, not interrupting or diverting you
    Really listening... (paying close attention to what you were saying, not looking at the notes or computer as you were talking).
    Being interested in you as a whole person... (asking/knowing relevant details about your life, your situation; not treating you as ‘just a number’).
    Fully understanding your concerns... (communicating that he/she had accurately understood your concerns; not overlooking or dismissing anything).
    Showing care and compassion... (seeming genuinely concerned, connecting with you on a human level, not being indifferent or ‘detached’).
    Being positive... (having a positive approach and a positive attitude, being honest but not negative about your problems).
    Explaining things clearly... (fully answering your questions, explaining clearly, giving you adequate information, not being vague).
    Helping you to take control... (exploring with you what you can do to improve your health yourself, encouraging rather than ‘lecturing’ you).
    Making a plan of action with you... (discussing the options, involving you in decisions as much as you want to be involved, not ignoring your views).
    Overall, how would you rate your consultation today?
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Page last reviewed: 23 March 2021