Our mission is to maintain a dedicated, caring and knowledgeable team committed to providing exceptional patient services and Chiropractic Care. We strive toward this excellence through continuing education, technical advances and compassionate care for all of our patients. You can help us reach and maintain this level of service by sharing your chiropractic needs and expectations. By completing this survey, you will be a part of our team meetings and be assured that your comments will be discussed and acted upon. Thank you for your time and effort. (Please Note: Your privacy is 100% assured.)

* 1. How did you choose our practice?

  Yes No
A friend or relative recommended the practice
I drove by and saw your sign
I saw the practice in the Yellow Pages
Found you online (via search engine or web site)
On my insurance plan

* 2. Your Telephone Experience:

  Yes No
My call was answered promptly
It was easy to make an appointment
I was referred to the website to get necessary forms ahead of time
I was placed on hold too long
I was offered to be called back if needed

* 3. Your impression of our receptionist (over the phone):

  Yes No
Friendly and attentive
Courteous
Informative

* 4. Your impression of our receptionist (in person):

  Yes No
Stood and greeted me
Aware of purpose of visit
Seemed warm and cheerful
Gave me undivided attention
Seemed hospitable
Answered all my questions

* 5. Your impression of our reception area:

  Yes No
Comfortable
Neat & Clean
Retail displays are well organized
Child-friendly

* 6. Your impression of our website

  Yes No
I visited the website
The website was easy to navigate
I found the website to be helpful & resourceful
I printed out any necessary forms ahead of time
I liked your practice on facebook
I am open to receiving health related emails

* 7. Your impression of the doctor:

  Yes No
The doctor listened to my concerns
The doctor did a through examination
The doctor did a good job of answering my questions
The doctor addressed my problem

* 8. Name (optional)

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