This study was a descriptive and exploratory investigation of patient perceptions of treatment at an osteopathic training clinic. An open text questionnaire survey was administered by post in 2000 to all 292 patients attending the clinic in south-east England in 1998-2000. The response rate was 62%. The data were transcribed and the concepts within the data were coded using grounded theory, within an interpretive phenomenological approach. The emergent core theme "underlying personal values" describes how patients manage their search for health. Four main themes were associated with the therapeutic relationship: hope, communication, respect, and trust. Two further themes emerged: one related to the environment of a teaching clinic; and a cross-checking theme described comparisons of the clinic with NHS services and other services. The majority of patients expressed satisfaction with treatment, the explanations they received and their perceived health outcomes. The question about comfort with the manner of treatment drew out important issues around undressing, privacy and gender. This was the first study of patient attitudes in an osteopathic training clinic and has implications for their organization and service delivery. Recommendations are made for the design of future studies in this area.