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Home
Plans & Pricing
Our Services
- Computer Adjustment
Contact Us
FAQ's
Helpful Links
- Video and Podcasts
- Survey

Office Quality Survey:

What is the primary reason you prefer to be seen? *

Pain/Symptom relief Improved Function Improved overall health Preventative measures Stress relief Condition control

* Indicates required field

Rate the Office *

Above average Average Below average Unacceptable

What can we do to improve? *

Rate your provider *

Very Satisfied - I would refer anyone Satisfied - I would refer, but have some hesitation Neutral - I would refer on rare conditions Unsatisfied - I would recieve care, but not refer Very Unsatisfied - I don't plan on returning

If not satisfied, please give reason below: *

Availability - I can be seen - *

Any of the times I want Most of the times I want Some of the times I want Occasionally when I want I always have to arrange my time to be seen

What times work better for you? *

Affordability - Fees are: *

Very reasonable Reasonable Acceptable Tolerable Expensive

Please list the services you recieve *

Please provide any additional comments you feel would help us improve *

Submit

Finding Us Survey:

* Indicates required field

How did you hear about this site? *

Internet Search Advertisement Friend Other

If Other please specify: *

What is your age? *

Less than 13 13-18 19-25 26-35 36-50 Over 50 Prefer not to say

What is your household income? *

Less than $10,000 $10,001 - $25,000 $25,001 - $40,000 $40,001 - $70,000 $70,001 - $100,000 Greater than $100,000 Prefer not to say

Submit