Feedback Questionnaire | Back In Shape

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These Questions Refer To Your Time Before Back In Shape.

How long do you typically wait before seeking help for back pain?

At the first sign of pain After a week of pain After a month of pain Wait until the pain is unbearable

What's the maximum number of different medications you've taken to get through the pain?

Has back pain caused you to do any of the following

Take time off work Miss a social gathering Take time off from a hobby or past-time Cancel or reschedule a holiday

What treatments have you previously tried

Physiotherapy Osteopathy Chiropractor Massage Acupuncture Injections Surgery Other

If Other Please Specify

How satisfied have you been with the success of previous treatments getting to the root of the problem

These Questions Refer To Your Time During Back In Shape

What's Your Current Premium Membership Status

Member Past Member Never Been A Member

What's the one thing you'd like to get from the program as a whole that is currently missing?

Would you recommend the program to a friend/family member struggling with back pain or sciaitca?

Yes No

How would you rate the program out of 10 (1 being bad and 10 being great)

How would you rate the support out of 10 (1 being bad and 10 being great)

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Would you be happy to share a headshot photo & short testimonial for our website to help us spread the word to others?

Yes No

Thank You For Helping Us! Submit Your Answers Anonymously Using The Button Below

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Feedback Questionnaire

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