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Print this out and mail it in or bring it in. Madison Companion Animal Hospital Client Survey At our hospital, we strive for 100% satisfaction. We genuinely look forward to greeting pet owners concerned enough to seek care for their pets at the earliest stages where diseases are more likely to be cured, rather than controlled. If you are not satisfied with something, please let us know and weČll do our best to make it right! WeČre committed to your 100% satisfaction. Please take a few moments to complete the survey below so that we may better serve you and your pets. How do you feel about our staff skills? Front Desk Receptionist ____________________________________________________________ Exam Room Assistant ______________________________________________________________ Animal Technician _________________________________________________________________ How do you feel about our staff helpfulness? Front Desk Receptionist ____________________________________________________________ Exam Room Assistant ______________________________________________________________ Animal Technician _________________________________________________________________ Doctor(s) _______________________________________________________________________ How do you feel about the following: Ability to get a convenient appointment _________________________________________________ Reception area waiting time __________________________________________________________ Time allocated for your petČs needs_____________________________________________________ Patient care directions by Doctor______________________________________________________ Diagnostic skills of the Doctor________________________________________________________ Patient care directions by technician____________________________________________________ Patient care directions by receptionist___________________________________________________ Appearance of building exterior_______________________________________________________ Appearance of Reception area_________________________________________________________ Appearance of Exam Room___________________________________________________________ Were you satisfied with the value of the service you received?_________________________________ If not, please explain________________________________________________________________ _______________________________________________________________________________ Was this your first visit to our hospital?_________________________________________________ If no, how many visits have you made to our hospital in the last year?____________________________ How many visits have you made to another pet hospital this year?_______________________________ How did you find out about us?________________________________________________________ Other comments or concerns: ________________________________________________________ _______________________________________________________________________________ Thank you for your time and comments. They will help us do a better job to serve you and your pets. |