Exit this survey Acupuncture Survey 1. Acupuncture Survey A Short Questionnaire to gain feedback about people's experience of Acupuncture Treatment What is your name and how old are you? Question Title * 1. What is your name and how old are you? Where do you live? Question Title * 2. Where do you live? Name: Address: Address 2: City/Town: State: ZIP/Postal Code: Email Address: Phone Number: Please describe what you came to have Acupuncture for: Question Title * 3. Please describe what you came to have Acupuncture for: How did you benefit from treatment? Question Title * 4. How did you benefit from treatment? How would you describe your overall experience of having Acupuncture with Nicola? Question Title * 5. How would you describe your overall experience of having Acupuncture with Nicola? Did you experience any side effects to Acupuncture treatment? Question Title * 6. Did you experience any side effects to Acupuncture treatment? Please could you describe what you expected from Acupuncture treatment and whether the actual experience differed from your expectations in any way: Question Title * 7. Please could you describe what you expected from Acupuncture treatment and whether the actual experience differed from your expectations in any way: How long ago was your last session, and how are the problems now that you first came to have treatment for? Question Title * 8. How long ago was your last session, and how are the problems now that you first came to have treatment for? What did you value most about coming for Acupuncture Treatment? Question Title * 9. What did you value most about coming for Acupuncture Treatment? Would you recommend Acupuncture with Nicola to anyone? If so, please can you say who you would recommend it to and why: Question Title * 10. Would you recommend Acupuncture with Nicola to anyone? If so, please can you say who you would recommend it to and why: Done