Patient QR Code Rewards Entry

Please enter your information below so we can accurately track the amount of times you have scanned our QR Code. After we log 12 visit submissions + 1 Google Review on our Google Maps profile, you will get a FREE heavy duty “(Commercial grade) Chattanooga Ice pack.”
 
(Free items will/can change periodically).

 

When you fill out this form, our Google Maps Profile link will be displayed on the Thank You Page so you can ALSO give us a 5 star review. You will need a Google Account (i.e. Gmail) to login to give the review. If you do not have one, they are free to open and takes seconds to do. We really do appreciate it.