Prairielands Chiropractic Clinic - Chiropractor In Council Bluffs, IA USA

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Comment Card

Our mission is to maintain a dedicated, caring and knowledgeable team committed to providing exceptional client services and Chiropractic Care. We strive toward this excellence through continuing education, technical advances and compassionate care for all of our patients.

You can help us reach and maintain this level of service by sharing your chiropractic needs and expectations. By completing this client survey, you will be a part of our team meetings and be assured that your comments will be discussed and acted upon. Thank you for your time and effort.

(Please Note: Your privacy is 100% assured.)

Chiropractic:

Please rate your initial chiropractic visit.

ExcellentGoodAverageFairPoor

How has Chiropractic care benefitted you or someone in your family? *

Massage Service:

Was your initial visit comfortable?

ExcellentGoodAverageFairPoor

How would you rate...

Our massage services?

ExcellentGoodAverageFairPoor

The application of oil / lotion?

ExcellentGoodAverageFairPoor

Room temperature?

ExcellentGoodAverageFairPoor

Pillow / Bolster placement in massage?

ExcellentGoodAverageFairPoor

Comfort on the massage table?

ExcellentGoodAverageFairPoor

Comfort on the massage table face cradle?

ExcellentGoodAverageFairPoor

Talking during massage?

ExcellentGoodAverageFairPoor

Pressure throughout massage?

ExcellentGoodAverageFairPoor

Did any stretches in massage cause pain or feel uncomfortable?

YesNo

Wellness Classes

How would you rate...

Wellness instructors level of knowledge?

ExcellentGoodAverageFairPoor

Instructors presentation skills?

ExcellentGoodAverageFairPoor

Handouts?

ExcellentGoodAverageFairPoorNone Given

Instructors interest in meeting your needs?

ExcellentGoodAverageFairPoor

What is your overall opinion of the class?

ExcellentGoodAverageFairPoor

Which class was it, and who was the instructor?

Was this wellness class offered at convenient times for you to attend?

YesNo

What did you like most about the wellness class?

What did you like least about the wellness class?

Overall

How would you rate the attitude and helpfulness of the staff?

ExcellentGoodAverageFairPoor

Why do you continue receiving treatments from us?

Did any particular staff members performance stand out? Do you remember his/her name? If so, please share.

What do you like about Dr. Langille, your wellness instructor, or massage therapist?

What are your suggestions for improvement?

Client Experience Questionnaire

How did you choose our practice?

Your telephone experience:

Your impression of our receptionists (over the phone):

Your impression of our receptionist (in person):

Your impression of our reception area:

Your impression of our Parking Lot / Grounds:

Your impression of our website:

Your impression of our Doctor (check all that apply):

Introduced himselfListened to what I saidGave clear adviceAnswered all my questionsMade me feel valuedSeemed proficient and knowledgeableGave me the information I neededOther

If other, please explain:

Additional Questions:

Was your wait reasonable?

YesNo

Do you feel the fees were reasonable?

YesNo

Did you understand all our fees?

YesNo

Will you reccommend us to others?

YesNo

Why or why not?

What suggestions do you have for improving the office, staff, or procedures?

May we quote your comments in a testimony?

YesNo

Name (optional):

Email (optional):

Phone (optional):

Would you like us to contact you?

YesNo

Enter the verification code in the box below.

Verification Code: *

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Office Hours

Mon	8 - 12	12 - 7
Tue	8 - 12	12 - 7
Wed	8 - 12	12 - 7
Thu	8 - 12	12 - 7
Fri	8 - 12	12 - 7
Sat	8 - 2	Closed
Sun	Closed	Closed

Call Us:
(712) 256-2561

Contact

Prairielands Chiropractic Clinic
300 West Broadway, Suite 712
Council Bluffs, IA 51503
Get Directions

Phone: (712) 256-2561
Fax: (712) 256-1927
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Comment Card

Chiropractic:

Massage Service:

Wellness Classes

Overall

Client Experience Questionnaire

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