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