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Client Satisfaction Survey

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Client Satisfaction Survey
Who is your regular Practitioner? *This question is required.
How well do you feel we have addressed your initial reason for popping in to see us?
1 (poorly) 10 (extremely well) *This question is required.
Please rate your current level of satisfaction in the following health related areas (1 being poor and 10 being outstanding). *This question is required.
1
 
10
Posture
Flexibility
Sleep
Digestion
Energy Levels
Mood
Sleep quality and feeling of being well rested upon waking
Ability to recover from stressful events
Do you feel like you were provided with enough information about your current state of health and why getting adjusted regularly would help & maintain this?
Do you know what a 'subluxation' is? *This question is required.
Is it a:
"Subluxation" is a term Chiropractors use to describe nerve interference in the body. Subluxation primarily involves spinal joint dysfunction causing corresponding nerve, muscle and organ dis-ease.

Chiropractic is currently the only profession in the world whose whole primary purpose is to remove subluxation and allow clear neurological communication between the brain and body.
Were you aware that we look after many families and children from as young as several hours old? *This question is required.
Chiropractic has many benefits for young growing bodies. By making sure they are in great shape while developing, they will reap the benefits which can include, increased hand eye coordination, improved concentration levels and increased growth and development. More information can be found by visiting our website: www.putneychiropractic.co.uk/family-and-chiropractic/
We would love to see you again soon. Is there any reason that is making it difficult for you to pop back in?

Please select from as many of the boxes below as you require.

If we can find a way to work around any of your selections to help you, we will endeavor to do so. *This question is required.
You mentioned you were not completely satisfied with your experience. Please accept our apologies for this. We would love to make it up to you.

One of the great benefits of visiting our practice is it's size. We have several practitioners with different personalities, approaches and philosophies.

Didn't have a great experience with your current practitioner?

Not to worry, we would be more than happy to arrange for you to see a different practitioner for a complimentary consultation. Would you like us to get in touch to arrange this? *This question is required.
1. Do you currently follow us on: *This question is required.
Space Cell YesNo
Facebook *This question is required
Twitter *This question is required
Instagram *This question is required
Youtube *This question is required
If you would like to follow us for the latest health and well being news (& some fun!) you can find us at:

www.facebook.com/putneychiropractic
www.twitter.com/putneychiro
www.instagram.com/putneychiropractic
www.youtube.com/user/PutneyChiro
2. Would you reccommend Putney Chiropractic Centre to your family and friends? *This question is required.
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