Empire Physiotherapy Evaluation

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Where did you here about us?* This field is required.

2

WebsiteWhat did you think of our website

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Overall, were you satisfied with the facilities we use?* This field is required.

Yes

No

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Please add any additional comments here?

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Would you recommend Empire Physiotherapy to a friend?* This field is required.

Yes, definitely

Maybe, if it was cheaper

No, never

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Is there any aspect of our service that you would like us to change?

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Any final comments?

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Your Name

First Name

Last Name

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E-mail

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Phone Number

Area Code

Phone Number