Satisfaction Survey

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Satisfaction Survey

Satisfaction Survey

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5Questions

HIPAA

Compliance

1
Overall, how would you rate BackSmith Chiropractic?
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2
Please rate Dr. Smith, with 0 being bad and 10 being good, on the following:
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Improved my condition(s)
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Knowledge
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Trustworthiness
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Professionalism
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Adjusting Skill
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Friendliness
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Other
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Improved my condition(s)
Knowledge
Trustworthiness
Professionalism
Adjusting Skill
Friendliness
Other
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3
Dr. Smith is always looking to improve his level of service and care. Please tell us what we can do better.If you answered "Other" on question 2 please describe what you mean
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You may remain anonymous or enter your name
First Name
Last Name
5
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