Patient Satisfaction Survey
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1. Please answer the following questions
100%
A few brief questions to measure our service to our patients
1
. How satisfied are you with the quality of service provided by the support staff of Daniels Chiropractic Office Inc?
How satisfied are you with the quality of service provided by the support staff of Daniels Chiropractic Office Inc?
Very satisfied
Satisfied
Unremarkable
Dissatisfied
Very dissatisfied
Any comments on your response
2
. How satisfied are you with the quality of service provided by the doctors of Daniels Chiropractic Office Inc., including Dr. Sally Brown?
How satisfied are you with the quality of service provided by the doctors of Daniels Chiropractic Office Inc., including Dr. Sally Brown?
Very Satisfied
Satisfied
Unremarkable
Dissatisfied
Very Dissatisfied
Any comments on your reponse
3
. When I enter Daniels Chiropractic Office Inc
Strongly Agree
Agree
Disagree
Strongly Disagree
I am greeted with a smile
*
When I enter Daniels Chiropractic Office Inc I am greeted with a smile Strongly Agree
I am greeted with a smile Agree
I am greeted with a smile Disagree
I am greeted with a smile Strongly Disagree
I feel welcomed
I feel welcomed Strongly Agree
I feel welcomed Agree
I feel welcomed Disagree
I feel welcomed Strongly Disagree
it seems like an exciting place to be
it seems like an exciting place to be Strongly Agree
it seems like an exciting place to be Agree
it seems like an exciting place to be Disagree
it seems like an exciting place to be Strongly Disagree
4
. How likely is it that you would refer someone to our office?
How likely is it that you would refer someone to our office?
Very Likely
Likely
Neutral
Unlikely
Very Unlikely
Any comments on your response
5
. How would you describe the results you have had with chiropractic care?
How would you describe the results you have had with chiropractic care?
A. Better than expected
B. As expected
C. Neutral
D. Not as I expected
Comments
6
. What do you like the most about Daniels Chiropractic Office Inc.?
What do you like the most about Daniels Chiropractic Office Inc.?
7
. If you could change one thing about Daniels Chiropractic Office Inc. what would it be?
If you could change one thing about Daniels Chiropractic Office Inc. what would it be?
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