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How Did We Do?
Step
1
of
8
12%
How did you find out about us?
*
Internet Search
Social Media
Friend or Family Referral
Licensed Professional Referral
Driving by the Practice
Insurance Provider's List
Promotional Flyer
Marketing Event
Other
For my first appointment I was seen...
*
Late
On Time
The practitioner's listening skills were...
*
Disappointing
Not so great
Neutral
Pretty good
Excellent
The explanations I received were...
*
Unclear
Somewhat Unclear
Neutral
Clear
Excellent
The helpfulness of the staff was...
*
Very Unhelpful
Unhelpful
Neutral
Pretty Helpful
Excellent
Confidence that I can be helped...
*
Hopeless
Somewhat Hopeless
Neutral
Somewhat Hopeful
Hopeful
My overall visit experience was...
*
Disappointing
Not Great
Average
Good
Excellent
Anything else you'd like to share with us?
May we share your words (and first name only) on our website to encourage others?
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