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Dear Patient,

We would be grateful if you would complete this survey about the chiropractic clinic you attend, keeping a TYPICAL visit to that clinic in mind.

The chiropractors at your clinic want to provide the highest standards of care. They, along with chiropractors from other clinics around the country, are sending this questionnaire to their patients so they can identify things that may need improvement. Your opinions are therefore very valuable.

Please answer ALL the questions that apply to you. There are no right or wrong answers and your chiropractor will NOT be able to identify your individual responses.

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1. In the past 12 months, HOW MANY TIMES have you seen a chiropractor at your clinic?

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2. How do you rate the way you are treated by the RECEPTIONIST/S at your clinic?

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3. How do you rate the HOURS that your clinic is open for appointments?

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4. What ADDITIONAL HOURS would you like the clinic to be open? (please tick all that apply)

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