We are having some of our patients fill out testimonials for us. Getting it on paper has been difficult, and some people asked if I could put it on the internet, it would make it easier to fill out.
There is also a button at the bottom of this form which will allow you search your computer for a picture to upload with this form. We really want to attach pictures of our patients doing the things they love to do the most now that they are feeling better. If you don't have one you like, or you just don't want to, don't worry about it.
We value your input. Please use the following outline for a brief description of your experience with Dr. Koch and the chiropractic care you've received. We may use your response to share with other patients. If you have a favorite photo of you doing the things you love the most, please bring it in and we can scan it, or attach it to this email.
Thanks!

What was your original complaint or health problem? "I used to have..."

"For the last hundred years...Drugs didn't work"

How bad was it (at its worst)? "On a scale of 1-10, mine was 34!"

How did it affect your life? What did it stop you from doing? "I couldn't...."

Why did you choose Dr. Koch? "He came highly recommended..."

How are you doing now? "Now I feel fantastic!"

How has it affected your life? "Once again, I can leap tall buildings in a single bound!"

  Not only do I sleep better, but everything I do with my right hand, I do better.
 

What other aspects of your health have improved? "I no longer have allergies!"

Please provide the following contact information:

Name
E-mail