How were you referred to our office?

FriendDrove ByInternet / WebsiteNewspaper / OutlookOther (please specify below)

Our receptionist(s):

Stood and greeted you right awayWere warm and cheerfulGave their undivided attentionSeemed indifferent

Our Parking Lot / Grounds:

Adequate parkingInadequate parkingCleanLittered or unkept

When you telephoned:

Your call was answered promptlyThere was a long wait for an answerYou were placed on hold too long

Our waiting room was:

ComfortableNeat and CleanUncomfortableDisorderlyOdor-freeNeeded odor controlChild-friendly

Your phone conversation was:

CourteousHurriedImpolitePreoccupied

Our office hours are:

ConvenientRestrictiveShould be open moreI would use different hours (please specify below)

Our Technician:

Greeted you warmlyWas gentle with your petWas knowledgeableMoved to exam room in a timely mannerWas a poor communicatorNeeds more training

The Veterinarian:

Introduced him/herself with a warm greetingAcceptable in manner and appearanceInferior in manner and appearanceGood at comforting me and my petAble to make me feel like a friendInsensitive in his/her use of people skills

Was your waiting time reasonable?

yesno

Did you understand our fees?

yesno

Do you feel the fees were reasonable?

yesno

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

Why did you choose this hospital?

Would you recommend us to your friends and family?

yesno

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

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