Patient Satisfaction SurveyName (Include your name & email address receive $10 off your next visit) First Last Email Please indicate type of care received:* Chiropractic Adjustment Shockwave Therapy Massage TherapyI received excellent care* Agree DisagreeThe Doctor / RMT had a good understanding of my problem* Agree DisagreeThe staff answered all my questions* Agree DisagreeI feel better/healthier as a result of my visit* Agree DisagreeI would recommend this office to my friends and family* Agree DisagreeComments:Δ
