Share your story

It is our goal to provide you the highest quality services, and we would like to know how we are doing. If you have been a patient in our office, past or present, we would appreciate your help on learning what we are doing well and what we may be missing. None of the information is required, so please fill out only those sections with which you feel comfortable.


Your Name

Your E-mail Address

What health concern originally brought you to Wilderness Chiropractic?

What was the outcome of your treatment?

Did you experience any other changes that were not related to your original complaint? If so, what were they?

What made you choose Wilderness Chiropractic?

Did you have any preconceived ideas of Chiropractic before beginning care, and how did those change with treatment?

What was your biggest obstacle in seeking treatment? How was that obstacle overcome?

What were your impressions, good or bad, of your care at Wilderness Chiropractic?

Would you recommend Wilderness Chiropractic? If so, why?

Is there anything else you would like to add?

Do we have your permission to use your testimonial in our marketing materials? If so, would you prefer any form of anonymity (ie. no last name, anonymous, etc.)