Physical Therapy Session Progress Feedback — Form Fields
This feedback template includes 10 fields. Track patient-reported progress and satisfaction after physical therapy sessions. Free to customize and use on ZenBuild.
Patient Name (text, optional)
Treating Therapist Name (text, required)
Number of sessions completed so far (dropdown selection, required) — options: 1-3, 4-6, 7-10, 11-15, More than 15
Pain Level Improvement Since Starting PT (rating, required)
Progress Toward Recovery Goals (rating, required)
Therapist Communication and Care (rating, required)
Quality of Exercise Instructions (rating, required)
Are you performing home exercises as prescribed? (multiple choice, required) — options: Yes, consistently, Most of the time, Occasionally, No
Concerns or challenges with treatment progress (long text, optional)
