Home
Staff
Offices
Services
New Patients
Contact Us
Why Patients See Us
Patient Education
Health & Wellness for a LIFETIME
Quincy
Dorchester
Roslindale
Attleboro
Brockton
Weymouth
Taunton
Somerset
Appointment Request
Patient Education
What is Chiropractic
Benefits of Chiropractic Care
Your First Visit
Adjustments
Ice Therapy
Heat Therapy
Back Pain
Leg Pain
Neck Pain
Spinal Decompression
Ideal Protein Weight Loss
Ergonomic Assessments
Web Friends
Success Stories
Recent Blog Posts
First Name
Last Name
E-mail
To Your Health Newsletter
June, 2013 (Vol. 07, Issue 13)
Article Index
The Truth About Salt
The Sunscreen Dilemma
High-Risk Moments for Your Low Back
Get Healthy the Natural Way
Liquid Nutrition
Protect Your DNA From Disease With Omega-3
Boost Your Immune System the Right Way
Are Cheat Reps OK to Help Build Muscle?
Get Kids Off the Couch This Summer
Vitamin C: Essential for Your Health
Archives
Questionnaire
Which location did you visit?
Quincy
Dorchester
Roslindale
Attleboro
Brockton
Weymouth
Taunton
Somerset
How would you rate the cleanliness of the clinic?
Very Bad
Poor
Average
Good
Excellent
How comfortable is the clinic?
Very Bad
Poor
Average
Good
Excellent
The friendliness of the service is:
Very Bad
Poor
Average
Good
Excellent
The efficiency of the service is:
Very Bad
Poor
Average
Good
Excellent
Convenience of appointment times:
Very Bad
Poor
Average
Good
Excellent
Explaination of your problem and treatment:
Very Bad
Poor
Average
Good
Excellent
Satisfaction with treatment outcome:
Very Bad
Poor
Average
Good
Excellent
How was your chiropractor's manner?
Very Bad
Poor
Average
Good
Excellent
Cost of treatment:
Very Bad
Poor
Average
Good
Excellent
Generally waiting times are:
Very Bad
Poor
Average
Good
Excellent
Satisfaction overall:
Very Bad
Poor
Average
Good
Excellent
Based on these experiences I would recommend the clinic to friends/family:
Rarely
Sometimes
Often
Any other thoughts or ideas (optional):
Your Name (optional)
Would you like us to contact you to discuss your experience?
Yes
No
Thank you indeed for taking the time to complete this questionnaire. Your answers will ensure we continue to improve our service.