---
title: Chiropractic Patient Acquisition and Retention Survey Template | Paperform
description: Market research survey for chiropractors to analyze patient acquisition channels, treatment frequency, insurance preferences, wellness program interest, and referral motivations.
url: "https://paperform.co/templates/chiropractic-practice-patient-acquisition-retention-study"
type: static
generatedAt: "2026-03-28T00:43:18.668Z"
---

[← Back to free form templates](/templates/)    ![Chiropractic Practice Patient Acquisition & Retention Study](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/chiropractic-practice-patient-acquisition-retention-study.png)
    [Preview](https://_preview.paperform.co/ai-template/chiropractic-practice-patient-acquisition-retention-study) [Use this template for free](/create?ai-template=chiropractic-practice-patient-acquisition-retention-study)    [Surveys & Questionnaires](/templates/category/surveys/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/)[Chiropractic & Alternative Medicine](/templates/industry/chiropractic/) [Marketer](/templates/role/marketer/)[Chiropractor](/templates/role/chiropractor/)[Healthcare Administrator](/templates/role/healthcare-admin/)[Researcher](/templates/role/researcher/)     About this free form template
Understanding what attracts patients to your chiropractic practice—and what keeps them coming back—is essential for sustainable growth. This **Chiropractic Practice Patient Acquisition & Retention Study** template helps you gather actionable consumer insights on treatment frequency patterns, insurance coverage importance, wellness program interest, and the motivations behind patient referrals.

Built for chiropractic practices, wellness clinics, and healthcare market researchers, this survey covers the full patient journey: how people discover chiropractic care, what drives their treatment decisions, which services they value most, and why they recommend (or don't recommend) your practice to others.

With Paperform, you can brand this survey to match your practice identity, embed it on your website, or share it via email and social channels. Use conditional logic to tailor follow-up questions based on patient experience, and let **AI Insights** automatically summarize hundreds of responses into clear themes and actionable recommendations—no spreadsheet analysis required.

Connect responses to your CRM, project management tools, or Google Sheets using **Stepper** (stepper.io) workflows to trigger follow-up campaigns, route feedback to your team, or segment patients for targeted wellness programs. You can also use **Papersign** (papersign.com) to turn interested survey respondents into enrolled wellness program members with seamless eSignature collection.

Whether you're launching a new service, refining your patient experience, or planning your next marketing campaign, this template gives you the consumer insights you need to make data-driven decisions that improve both patient acquisition and long-term retention.
       Built for growing businesses, trusted by bigger ones.   Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.     ![Capterra - 4.8 out of 5](/images/capterra-st.jpg)
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