Universal Chiropractic needs your feedback! Please take a moment and help us to improve the experiences of future patients and provide better care. When you complete this survey you have a 1 in 10 chance of winning a free 10-minute chair massage from our new massage therapist. 
Thank you!

* 1. Your name, the date of your first visit, and your email (so we can let you know if you've won the chair massage). 

* 2. What is your Chiropractor's name?

* 3. Ease of getting care

  Strongly Disagree Disagree Neutral Agree Strongly Agree
It was fast and easy to schedule my appointment.
I was able to be scheduled for an appointment the same day. 
I was able to be scheduled with the doctor of my choice.
The staff was very courteous while setting up my appointment.
The staff answered all my questions about my visit.
All phone calls were returned in a timely manner.
It was easy to find a park spot.
The office is in a convenient location.

* 4. Waiting Time

  Strongly Disagree Disagree Neutral Agree Strongly Agree
I did not have to wait long to schedule an appointment
I did not have to wait long in the waiting room.
I did not have to wait long in the exam room.
I did not have to wait long between services.

* 5. Your Chiropractor

  Strongly Disagree Disagree Neutral Agree Strongly Agree
The Chiropractor was courteous and friendly.
The Chiropractor spent enough time with me during my visit.
The Chiropractor explained my injury/problem to me in a way I could understand.
The Chiropractor showed concern for my questions and worries.
The Chiropractor was able to answer my questions and sufficiently explain my plan of care.
The Chiropractor provided a comfortable and inviting atmosphere.
The Chiropractor was thorough and gave me a great sense of confidence in his ability to help me.
I would recommend this Chiropractor to a friend.
When I'm treated by other Chiropractors in the office, the care is just as good. 

* 6. Care and Outcomes

  Strongly Disagree Disagree Neutral Agree Strongly Agree
My treatment plan is specifically designed for me and addresses all of my complaints.
My treatment was comfortable and did not worsen my symptoms.
My symptoms have improved since my treatment began. 
I will continue with my treatment plan as recommended to the best of my ability. 
I am interested in receiving nutritional counseling from my Chiropractor. 
I am interested in using Chiropractic to improve my athletic performance.
I am interested in continuing with Chiropractic care after my symptoms resolve to prevent future aches and pains. 

* 7. Staff

  Strongly Disagree Disagree Neutral Agree Strongly Agree
The receptionist that worked with me was friendly, knowledgeable and professional.
The chiropractic assistant that worked with me was friendly, knowledgeable and professional.
The staff was helpful in answering my questions and concerns.
Paying for services was quick and easy. 
The cost of Chiropractic care is a better value compared to other treatment methods.

* 8. How could we have made your Chiropractic experience better?

* 9. Are there any individuals you would like us to recognize for their outstanding service? If yes, please explain why. 

* 10. Please leave a review we can use in our marketing campaigns to let patients know what you love most about Universal Chiropractic! 

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