Chiropractic Practice Assessment Questionnaire (CPAQ) Please enable JavaScript in your browser to complete this form. - Step 1 of 4Dear Patient, We would be grateful if you would complete this survey about the chiropractic clinic you attend, keeping a TYPICAL visit to that clinic in mind. The chiropractors at your clinic want to provide the highest standards of care. They, along with chiropractors from other clinics around the country, are sending this questionnaire to their patients so they can identify things that may need improvement. Your opinions are therefore very valuable. Please answer ALL the questions that apply to you. There are no right or wrong answers and your chiropractor will NOT be able to identify your individual responses. 1. In the past 12 months, HOW MANY TIMES have you seen a chiropractor at your clinic? * None 1 or 2 times 3 or 4 times5 or six times 7 or more times2. How do you rate the way you are treated by the RECEPTIONIST/S at your clinic? *Very poor PoorFair Good Very goodExcellent3. How do you rate the HOURS that your clinic is open for appointments? *Very poor PoorFair Good Very goodExcellent4. What ADDITIONAL HOURS would you like the clinic to be open? (please tick all that apply) * Early morningLunchtimesEveningsWeekendsNone, I am satisfied Next(a) How QUICKLY do you get to see that chiropractor? (choose one item from each list) *Same dayNext working day2 working days or less3 working days or less4 working days or less5 or more working daysDoes not apply(b) How do you rate this? *Very poorPoor FairGoodVery GoodExcellentDoes not apply(a) How QUICKLY do you get to see that chiropractor? (choose one item from each list) *Same dayNext working day2 working days or less3 working days or less4 working days or less5 or more working daysDoes not apply(b) How do you rate this? *Very poorPoor FairGoodVery GoodExcellentDoes not apply7. If you need to see a chiropractor URGENTLY, can you normally get seen on the same day? *YESNODon't know/never needed to (a) How LONG do you usually have to wait at the clinic for your appointment to begin? *5 mins or less6 to 10 mins11 to 20 mins21 to 30 mins30 mins or more5 or more working days(b) How do you rate this? *Very poorPoor FairGoodVery GoodExcellentDoes not apply a) Ability to get through to the clinic on the phone? *Very PoorPoorFairGoodVery GoodExcellentDon't know/never triedb) Ability to speak to a chiropractor on the phone when you have a question or need advice? *Very PoorPoorFairGoodVery GoodExcellentDon't know/never triedNext10. The remaining questions ask about your usual chiropractor. If you don't have a 'usual chiropractor', please answer about the chiropractor who you know best at your clinic.If you don't know any of the chiropractors, please indicate this below, otherwise click 'Next'. *I don't know any of the chiropractors Next11. Finally, it will help us to fully understand your answers if you could tell us a little about yourself. Are you: *Male Female 12. To which AGE GROUP do you belong? *19 or younger20 to 2930 to 39 40 to 49 50 to 59 60 to 69 70+ 13. To which ETHNIC GROUP do you belong? * WhiteBlack or Black AmericanAsian or Asian American Mixed Chinese Other ethnic group 14. Which of the following BEST DESCRIBES you? (please tick one box) *Employed (full or part time, including self-employed) Unemployed and looking for work At school or in full time education Unable to work due to long term sickness Looking after your home/familyRetired from paid work Other PreviousSubmit