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Client Feedback

Email or Telephone:

During your most recent visit to Orthotics East, which of the following service(s) did you receive?

(Please check all that apply)

For those services that involved a Certified Pedorthist, which Pedorthist assisted you during your visit?

For those services that involved a Certified Pedorthist, please describe your overall satisfaction with the appointment:

In regard to the overall quality of your custom orthotic/footwear (after adjustments), please indicate your level of satisfaction:

Have you experienced trouble with any of the following?

 
YesNo