Thank you for visiting Focus Lifestyle
We’re always looking for ways to serve you better. This quick survey will take less than 2 minutes, and as our way of saying thank you for your time, you’ll receive $10 off your next visit.
Name
*
Email
*
example@example.com
How satisfied were you with your overall experience at Focus Lifestyle?
*
Highly dissatisfied
1
2
3
4
Highly Satisfied
5
1 is Highly dissatisfied, 5 is Highly Satisfied
Which of the following services have you used at our clinic? (Select all that apply)
*
Anti-aging treatments (Botox, fillers, facials)
Peptide therapy
Stem cell/regenerative treatments
Hormone therapy (BHRT)
Medical weight loss
Other (please specify)
*
How likely are you to recommend Focus Lifestyle to a friend or family member?
Not at all likely
1
2
3
4
Highly likely
5
1 is Not at all likely, 5 is Highly likely
What did you enjoy most about your visit?
What can we do to improve your experience?
Submit
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