Arora Family Chiropractic
1.
What services have you tried with us in the past?
Chiropractic
Athletic Therapy
Physiotherapy
Massage
Shockwave Therapy
Spinal Decompression
Custom Orthotics
Acupuncture (provided by Dr. Cook/Ashley/Dan)
2.
Which of the below services at our clinic would interest you in the future?
Chiropractic
Athletic Therapy
Physiotherapy
Massage
Shockwave Therapy
Spinal Decompression
Custom Orthotics
Acupuncture (provided by Dr. Cook/Ashley/Dan)
Post-partum Treatment
Health-related classes/educational sessions
Meditation or mindfulness services
3.
Which conditions are you most interested in getting treatment for?
Neck or back pain
Migraines/headaches
Sciatic pain
Other types of nerve pain - numbness/tingling
Knee Pain
Shoulder Pain
Dizziness/Vertigo/Ear pain
Post-partum pain
General health and wellness/maintenance/prevention
4.
How important is direct billing for you?
Extremely important
Very important
Somewhat important
Not so important
Not at all important
5.
How important is collaborative care for you? ie. being treated by multiple practitioners?
Extremely important
Very important
Somewhat important
Not so important
Not at all important
6.
Based on your interaction with our clinic, how likely is it that you would recommend Arora Family Chiropractic to a friend or colleague?
Very likely
Likely
Neither likely nor unlikely
Unlikely
Very unlikely
7.
Is there anything that you think would improve our clinic/customer support?
8.
If you would like to be entered in a draw for a $50 Amazon gift card, please write your name. If you are okay with us contacting you, type the word "Yes".