At Back In Alignment, we are committed to providing you with the very best patient experience. This anonymous survey will take less than one minute to complete, and will ensure that we are meeting your needs.

* 1. What is your gender?

* 2. What is your age?

* 3. What services did you seek from Back In Alignment? (Please check all that apply.)

* 4. Overall, how satisfied were you with the care provided by Back In Alignment?

* 5. How likely are you to recommend Back In Alignment to your friends and family?

* 6. How helpful was information or recommendations shared with you by Dr. Wilcox or the massage therapist during your visit?

* 7. What do you like best about Back In Alignment? What are we doing well that we should continue doing?

(Please note that we'd like to use anonymous quotes from satisfied patients on our Facebook page. If you do not want your remarks used anonymously on our page, just let us know that.)

* 8. What improvements would you suggest for Back In Alignment? What changes could we make to serve you better?

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