We welcome your feedback and your answers will be kept confidential. Please take a few minutes to fill out this survey on the timeliness and quality of the service you receive from our practice. Thank you for your participation.

    General Patient Information

    How would you rate our concern for you & your pet’s privacy?

    OutstandingGoodAdequateNeeds improvementPoorN/A

    How often have you visited our practice within the past year?

    First Visit2-5 VisitsMore then 6

    Scheduling Your Appointment

    Did you schedule an appointment by phone or did you drop in?

    Scheduled by PhoneScheduled OnlineDrop In

    If you scheduled an appointment, did you have to wait longer than expected?

    NoYes

    How easy was it to make an appointment by telephone?

    Very EasyEasyDifficultVery DifficultN/A

    How easy was it to make an appointment online?

    Very EasyEasyDifficultVery DifficultN/A

    Was the person who scheduled your appointment courteous and helpful?

    Very CourteousCourteousIndifferentRudeN/A

    Day of Your Appointment

    How would you rate the courtesy of the staff at the reception desk?

    Very CourteousCourteousIndifferentRudeN/A

    How long did you wait in the reception area beyond your scheduled appointment time?

    0-5 Minutes5-20 Minutes20-40 MinutesMore then 40 Minutes

    How long did you wait in the exam room before the veterinarian appeared?

    0-5 Minutes5-20 Minutes20-40 MinutesMore then 40 Minutes

    The Medical Support Staff

    Did the support staff member clearly identify themselves & their qualifications?

    YesNo

    How would you rate the competence of the technician/assistant who helped you?

    OutstandingGoodAdequateNeeds improvementPoorN/A

    How would you characterize the concern that the technician/assistant showed?

    OutstandingGoodAdequateNeeds improvementPoorN/A

    Did the technician/assistant respond to your requests within a reasonable period?

    YesNo

    How would you rate the professionalism and competence of the technician/assistant?

    OutstandingGoodAdequateNeeds improvementPoorN/A

    The Doctor

    Were you able to see the veterinarian of your choice?

    YesNo

    Did you feel that your veterinarian spent an adequate amount of time with you?

    YesNo

    What would describe the demeanor of your veterinarian?

    Attentive ConcernedDistractedRushed Inconsiderate

    How would you rate the competence of your veterinarian?

    OutstandingGoodAdequateNeeds improvementPoorN/A

    Did you feel that your veterinarian’s examination was thorough?

    YesNo

    How do you feel about the clarity of the veterinarian’s explanation of your pet’s condition & treatment options?

    OutstandingGoodAdequateNeeds improvementPoorN/A

    How well did your veterinarian include you in healthcare decisions?

    OutstandingGoodAdequateNeeds improvementPoorN/A

    Were your questions answered to your satisfaction?

    YesNo

    Would you recommend this facility and its staff to your family and friends?

    YesNo

    Additional Feedback

    Please list any areas in which our service could be improved...

    Please share any additional comments...


    I give permission for treatment and assume payment if my pet becomes ill while boarding.