How Were You Referred To Our Office?
Friend
Drove By
Website
Yellow Pages
Other (Please specify)

Our Parking Lot/Grounds:
Adequate parking
Inadequate parking
Clean
Littered or unkempt

Our Waiting Room Was:
Comfortable
Neat and clean
Uncomfortable
Disorderly
Odor-free
Needed odor control
Child-friendly

Our Office Hours Are:
Convenient
Restrictive
Should be open more
I would use later hours (please specify)

Our Receptionist(s):
Stood and greeted you
Were warm and cheerful
Were cold or unfriendly
Gave their undivided attention
Seemed indifferent
Were hospitable

When You Telephoned:
Your call was answered promptly
There was a long wait for someone to answer
You had trouble getting through
You were placed on hold too long

Your Phone Conversation Was:
Courteous
Hurried
Impolite
Informative
Preoccupied
I did not phone

Our Technician:
Greeted you warmly
Was gentle with your pet
Seemed proficient
Was knowledgeable
Was a poor communicator

The Veterinarian:
Introduced him/herself with a warm greeting
Listened well to my pet's present symptoms
Did not seem interested in what I had to say
Seemed in a hurry
Described the diagnosis and treatment well
Left me confused about how to treat my pet

The Veterinarian Was:
Professional in manner and appearance
Acceptable in manner and appearance
Inferior in manner and appearance
Good at comforting me and my pet
Able to make me feel like a friend
Insensitive in his/her use of people skills

Was your waiting time reasonable? Yes No

Did you understand our fees? Yes No

Do you feel the fees were reasonable? Yes No

If you checked "no" to any of the above questions, please discuss below:

Why did you choose this hospital?

Have you recommended us to others? Yes No

If so, why? (If not, why not?)

Was there anyone at the Animal Clinic & Hospital that provided you with exceptionally good or poor service?

If you were our practice manager, what suggestions would you have for improving the office, staff or procedures?