Patient Satisfaction Survey

It has been a practice of ours to provide the best possible care for our community. We need your feedback to ensure that our facility is doing just that! Please take a few minutes to complete the following survey; your dedication and honesty is greatly appreciated.

Staff
1. The staff is welcoming and friendly.





2. The staff is professional and knowledgeable.



3. The staff is helpful when I need assistance or have a question.



Comments:
 

Facility
1. The office is clean and inviting.



2. The temperature of the office is pleasant.



3. The layout of the office makes things easy to find.



4. The hours of operation work with your schedule.



Comments:
 

Efficiency
1. The doctor is prompt to see me at the appointed time.



2. The amount of time I had to wait for a return phone call was reasonable.



3. Check-in and check-out is done in a timely manner.



Comments:
 

Education/Knowledge
1. The information provided by the doctor was easy to understand.



2. I feel that I was educated about my treatment plan and treatments.



3. I am aware of all the services your office provides.



4. I’ve been educated on what my insurance coverage for this office is.



Comments:
 

Fees/Payments
1. I am always offered a receipt after making payment.



2. I believe the rate for adjustments is fair.



3. I believe the rate for massages is fair.



Comments:
 

If you wish to fill in your name, you will be entered into a drawing.
You will be eligible to win a $25 gift certificate of your choice.

Again, thank you for your participation in this survey!
 
Name:
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Satisfaction Survey
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Patient Satisfaction Survey