Lake Pointe Chiropractic Customer Satisfaction Survey Question Title 1. Rate your level of satisfaction with the services at Lake Pointe Chiropractic. Not Satisfied Neutral Very Satisfied N/A Chiropractic Chiropractic Not Satisfied Chiropractic Chiropractic Neutral Chiropractic Chiropractic Very Satisfied Chiropractic N/A Massage Massage Not Satisfied Massage Massage Neutral Massage Massage Very Satisfied Massage N/A Weight Loss Weight Loss Not Satisfied Weight Loss Weight Loss Neutral Weight Loss Weight Loss Very Satisfied Weight Loss N/A Pain Management Pain Management Not Satisfied Pain Management Pain Management Neutral Pain Management Pain Management Very Satisfied Pain Management N/A Other Services Other Services Not Satisfied Other Services Other Services Neutral Other Services Other Services Very Satisfied Other Services N/A If you were not satisfied with our servcies, why? Question Title 2. Rate the following statements on your level of agreement or disagreement. Strongly Disagree Disagree Agree Strongly Agree I am happy with the care I have received here. I am happy with the care I have received here. Strongly Disagree I am happy with the care I have received here. Disagree I am happy with the care I have received here. Agree I am happy with the care I have received here. Strongly Agree The staff was friendly during my visit. The staff was friendly during my visit. Strongly Disagree The staff was friendly during my visit. Disagree The staff was friendly during my visit. Agree The staff was friendly during my visit. Strongly Agree The wait time was less than 10 minutes. The wait time was less than 10 minutes. Strongly Disagree The wait time was less than 10 minutes. Disagree The wait time was less than 10 minutes. Agree The wait time was less than 10 minutes. Strongly Agree Question Title 3. Would you change anything about your experience at Lake Pointe Chiropractic? Question Title 4. Were you able to schedule your desired appointment time? Yes No Question Title 5. Were your financial obligations and health insurance explained clearly? Yes No Question Title 6. Would you come back to Lake Pointe Chiropractic? Yes No If Not, Why? Question Title 7. If you have not been in recently, why? Question Title 8. Would you refer Lake Pointe Chiropractic to your friends and family? Yes No Other (please specify) Done