Patient Satisfaction Survey Name (Include your name & email address receive $10 off your next visit) First Last Email Please indicate type of care received:*Chiropractic AdjustmentShockwave TherapyMassage TherapyI received excellent care*AgreeDisagreeThe Doctor / RMT had a good understanding of my problem*AgreeDisagreeThe staff answered all my questions*AgreeDisagreeI feel better/healthier as a result of my visit*AgreeDisagreeI would recommend this office to my friends and family*AgreeDisagreeComments:
