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Client Experience Survey Form
Please fill our Client Experience Survey Form carefully.
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Client Experience Survey
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CLIENT SURVEY
Our mission is to maintain a dedicated, caring and knowledgeable team committed to providing exceptional client service and Veterinary Health Care. We strive toward this excellence through continuing education, technical advances and compassionate care for all pets entrusted to us.
You can help us reach and maintain this level of service by sharing your veterinary needs and expectations. By completing this client survey, you will be a part of our team meetings and be assured that your comments will be discussed and acted upon. Thank you for your time and effort.
(Please Note: Your privacy is 100% assured.)
How Did You Choose our Hospital?
A friend or relative recommended the practice
*
Yes
No
I drove by and saw your hospital sign
*
Yes
No
Found you through the Search Engines
*
Yes
No
Other:
*
Your Telephone Experience:
My call was answered promptly
*
Yes
No
It was easy to make an appointment
*
Yes
No
I was referred to the hospital website to get necessary forms ahead of time
*
Yes
No
I was placed on hold too long
*
Yes
No
I was offered to be called back if needed
*
Yes
No
I did not phone
*
Yes
No
Your Impression of our Receptionist (Over the Phone):
Friendly and attentive
*
Yes
No
Courteous
*
Yes
No
Informative
*
Yes
No
Your Impression of our Receptionist (In Person):
Stood and greeted me
*
Yes
No
Aware of purpose of visit
*
Yes
No
Seemed warm and cheerful
*
Yes
No
Gave me undivided attention
*
Yes
No
Seemed hospitable
*
Yes
No
Answered all my questions
*
Yes
No
Your Impression of our Reception Area:
Comfortable
*
Yes
No
Neat & Clean
*
Yes
No
Counter tops free from clutter
*
Yes
No
Retail displays are well organized
*
Yes
No
Odor-free
*
Yes
No
Pet-friendly
*
Yes
No
Your Impression of our Parking Lot/Grounds:
Clean
*
Yes
No
I found a parking spot with ease
*
Yes
No
Your Impression of our Hospital Website
I visited the Pet Hospital Website
*
Yes
No
I found the website to be helpful & resourceful
*
Yes
No
I printed out any necessary forms ahead of time from the Hospital Website
*
Yes
No
I registered to be a member and/or to receive free newsletters
*
Yes
No
Your Impression of our Technician:
Greeted me with warmth
*
Yes
No
Was gentle with my pet
*
Yes
No
Seemed proficient and knowledgeable
*
Yes
No
Gave me the information I needed
*
Yes
No
Pet-friendly
*
Yes
No
Your Impression of our Veterinarian:
Introduced himself/herself
*
Yes
No
Washed his/her hands before examining my pet
*
Yes
No
Listened to what I said & answered all my questions
*
Yes
No
Gave clear advice about how to treat my pet
*
Yes
No
Behaved professional in manner and appearance
*
Yes
No
Answered all my questions
*
Yes
No
Comforted me and my pet
*
Yes
No
Made me feel valued
*
Yes
No
Additional Questions:
Was your waiting time reasonable?
*
Yes
No
Did you understand all our fees?
*
Yes
No
If you marked "No" please explain
Will you recommend us to others? Why or why not?
What suggestions do you have for improving the office, staff or procedures?
If you would like us to contact you, please fill out the necessary information.
Name
*
Email
*
Phone
Name
Submit