We Want To Know About Your
Experience At Our Clinic

If anything about your experience here is remarkable—in good ways or in ways that would let us improve—we want the feedback.

We are interested in your experience of naturopathic medicine itself, and we also care about the practical matters of financial transactions, pharmacy use, our newsletter, our staff and/or our physical space.

1.	I have seen Dr. Aagenes for approximately years OR number of visits.

2.	The reasons I came to the clinic are:


3.	The results I have experienced from naturopathic treatment are:


4.	The best things about the Natural Medicine Clinic are:


5.	The things I would like them to improve:


	Check here to give us permission to use your information on our web site. We will not use your name, just the content of your comments. If you do not check here your information will be held confidentially.

Name:

Date:

The Natural Medicine Clinic
1075 North Rodney, Suite 107
Helena, Montana 59601

(406) 442-8508
Fax (406) 442-2656

We Want To Know About Your Experience At Our Clinic

We Want To Know About Your
Experience At Our Clinic