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We’ve had the pleasure of serving hundreds of patients over the years, and when patients discontinue their care before optimum results are achieved, do not return for follow up evaluation or do not following through with diagnostic recommendations (x-rays, lab work), we get concerned.

Did we explain everything? Did we listen? Was the staff courteous? Were our hours convenient? We hope an office procedure or someone’s personality didn’t interfere with getting the care you needed.

To make sure our office continues to meet the needs of patients like you, we ask that you complete the enclosed questions below as it will only take a few minutes and your comments will be very important to us!

Female Male

Overall, how would you rate the care you received at Mark J. DeMalio D.C., Inc.

Excellent Good Fair Poor

Check the box(es) below that best describe your reason(s) for discontinuing care in our office.

Financial Reasons
Lack of Insurance Coverage
Conflict With Doctor
Conflict With Staff Member
Inconvenient Office Hours
Inconvenient Office Location
Ineffective Results
Painful Adjustments
Moved Out Of Area
Too Busy With Other Obligations
Chiropractic care just is not for me.

The results of this survey are confidential.

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