~ Grade: [5] Excellent & [1] Poor ~

Please select your grade from the corresponding dropdown menu for the following categories:

Overall cleanliness of the office:*

5
4
3
2
1
N/A
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Chiropractor’s willingness to listen carefully to you:*

5
4
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2
1
N/A
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Chiropractor taking time to answer your questions:*

5
4
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2
1
N/A
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Usefulness of our instructions for follow-up care:*

5
4
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2
1
N/A
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Chiropractor involved you in making decisions about your treatment:*

5
4
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2
1
N/A
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Chiropractor advised you on ways to stay healthy:*

5
4
3
2
1
N/A
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Quality of your chiropractic care:*

5
4
3
2
1
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Overall satisfaction with our office:*

5
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3
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1
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Would you recommend us to others?*

Definitely Yes
Probably Yes
Don't Know
Probably Not
Definitely Not
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