Customer Survey

* Age:
* Gender:
* What was the purpose of this visit?
Which chiropractor did you see?
If primary care medical services were available at AHW, would you use them?
* Ease of getting care
  • Excellent
  • Good
  • Fair
  • Poor
  • N/A
Ability to get in to be seen
Hours we are open
Convenience of our location
Prompt return on calls
* Waiting
  • Excellent
  • Good
  • Fair
  • Poor
  • N/A
Time in waiting room
Time in exam room
Waiting for tests to be performed
Waiting for test results
* Chiropractor
  • Excellent
  • Good
  • Fair
  • Poor
  • N/A
Listens to you
Takes enough time with you
Explains what you want to know
Gives good advice and treatment
Explains exercises and activities to help my condition
* All other staff
  • Excellent
  • Good
  • Fair
  • Poor
  • N/A
Friendly and helpful to you
Answers your questions
* Charges / Billing
  • Excellent
  • Good
  • Fair
  • Poor
  • N/A
Cost of service
Explanation of charges
Collection of payment
* Facility
  • Excellent
  • Good
  • Fair
  • Poor
  • N/A
Neat and clean building
Ease of finding where to go
Comfort and Safety while waitin
Privacy
* Please rate your perception of the professionalism portrayed by our office as a doctor's office responsible for your healthcare:
  • Excellent
  • Good
  • Fair
  • Poor
  • N/A
* Would you refer us to your friends or relatives?
What do you like best about Advantage Health and Wellness?
What do you like least about Advantage Health and Wellness?
If you have ended your treatment plan prematurely, please tell us why.
Suggestions for improvement: