Companion Animal Hospital Client Service Questionnaire

Thank you for giving us the opportunity to serve you. Please help us better meet your needs by taking a moment to complete our questionnaire as it relates to your visit to our hospital.
Your honest comments and suggestions will assist us in meeting our client's needs in the future.

Name (optional)

May we contact you regarding your input?

Yes

No

E-mail

Phone:

Please indicate which veterinarian you saw:

Please rate the following: (1)Unsatisfactory (2) Satisfactory (3) Good (4) Excellent

1. The attitude and courtesty of our front office staff?

1

2

3

4

2. The attitude and courtesty of our nursing/technical staff?

1

2

3

4

3. The attitude and courtesty of our veterinarians?

1

2

3

4

4. The attitude and courtesty of our animal care/boarding staff?

1

2

3

4

5. The manner in which your telephone call was answered and handled?

1

2

3

4

6. The wait between check-in and seeing the veterinarian?

1

2

3

4

7. The cleanliness of our hospital and grounds?

1

2

3

4

8. Did you feel a clear explanation was given regarding your pet's condition?

Yes

No

9. Were you given ample opportunity to ask questions regarding your pet?

Yes

No

10. Were you satisfied with the promptness of the check-out process?

Yes

No

11. Based on this experience, will you return to our hospital?

Yes

No

12. Would you refer us to your family and friends?

Yes

No

13. Overall, did we meet or exceed your expectations?

Exceeded

Met

Did not meet

14. Overall, how would you rate your visit to Companion Animal Hospital?

1

2

3

4

Specific comments are greatly appreciated!

Thank you for your time.
Please click on "Submit" below.

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Dr. Ritchie	Dr. Chan
Dr. French	Dr. Goldthwaite
Dr. Cloud	or Technician appointment