Greater West Physiotherapy

Patient Questionnaire

This questionnaire consistes of 4 questions. Each answer will give a different score. At the end the score will be tallied and a recommendation will be given.

I prefer to respond anonymously:

No Yes

Name

How long have you had your injury or pain?

Less than one week
One week to one month
One month to three months
More than three months
I have no pain

How intense is your pain?

Keeps me awake at night and is very intense
I have constant nagging pain, but I can sleep at night
I have pain now and then, but it does bother me
I rarely get my pain, when I do it is mild
I don’t have any pain

How would you describe the progress of your injury or pain?

Not getting any better or worse it just stays the same
It is getting better as time goes on
It is getting worse the longer I leave it
I’m not sure yet, I only recently did it
It comes and goes, but is starting to occur more frequently

Does your pain or injury prevent you from doing any activities?

Yes - I have been unable to do most of the things I used to enjoy
Yes - I can do most things, but there are some things I avoid
No - I do everything, but I have pain
No - I do everything without pain

"Pain pain pain. That is all my husband ever talked about and we never went out. Thanks guys, we can finally go to the movies!"

Jane, Glenmore Park

Getting Started

We are primary care practitioners – no referral needed!
Clear and concise treatment plans
Quick and easy payment with HICAPS.
Complete the Patient Profiler Questionnaire.

Enquire Now

Don't wait til things get worse, enquire now!
24 hour response guarantee.Contact us here.

Our Difference

One on One treatment
Progressive and cutting edge manual therapy techniques (not just machines)
No waiting for long periods of time
Our goal: bring back the quality to health care. Our guarantee supports this.
Click here to find out more.

Locations

Penrith
St Clair
Glenmore Park Rehabilitation Centre
Glenmore Park Town Centre
Gym and Hydrotherapy - Mt Druitt, Penrith and St Marys
Click here for maps and contact details