CLIENT SURVEY
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How were you referred tou out hospital?
Friend
Drove by
Yellow Pages
Website
Facebook
Other
Our grounds were...
Clean
Littered,unkempt
Our waiting room was...
comfortable
neat and clean
uncomfortable
disorderly
odor free
need odor control
child friendly
Our office hours are....
Convenient
Restrictive
Other
Our receptionist(s) were...
Warm and cheerful
Cold and unfriendly
Gave undivided attention
Seemed indifferent
When you called our practice....
My call was answered promptly
There was a long wait for someone to answer
I had trouble getting through
I was placed on hold too long
I did not phone
Your phone conversation was....
Courteous
Hurried
Impolite
Informative
Preoccupied
I did not phone
Your technician/assistant was...
Greeted me warmly
Was gentle with my pet
Was not gentle with my pet
Seemed proficient
Was a poor communicator
Your veterinarian was....
Professional in manner and appearance
Acceptable in manner and appearance
Inferior in manner and appearance
Good at comforting me and my pet
Not good at comforting me and my pet
Insensitive in his/her use of people skills
Your wait time was....
Reasonable
Unreasonable
Other
Did you understand our fees?
Yes
No
Were our fees reasonable?
Yes
No
comments?
Why did you choose our hospital?
Have you recommended us to others?
Yes
No
Why or Why not?
what other suggestions might you have for improving our hospital, staff or procedures?
Date of visit
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