Client Experience Questionnaire Form

Thank you for choosing our veterinary hospital! We would love to know about your experience with us. If you’d like to share how you found your veterinary visit, please complete the form below.

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Client Experience Questionnaire Form

Please fill out this form as completely and accurately as possible so we can understand how your visit went. We deeply value your feedback!

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If you would like us to contact you, please fill out the necessary information.

Name *

First

Last

Phone *

Email *

CLIENT SURVEY

Our mission is to maintain a dedicated, caring and knowledgeable team committed to providing exceptional client service and Veterinary Health Care. We strive toward this excellence through continuing education, technical advances and compassionate care for all pets entrusted to us.

You can help us reach and maintain this level of service by sharing your veterinary needs and expectations. By completing this client survey, you will be a part of our team meetings and be assured that your comments will be discussed and acted upon.

Thank you for your time and effort. (Please Note: Your privacy is 100% assured.)

How Did You Choose our Hospital?

A friend or relative recommended the practice *

I drove by and saw your hospital sign *

I saw the practice in the Yellow Pages *

Found you through the Search Engines *

Other

Your Telephone Experience:

My call was answered promptly *

It was easy to make an appointment *

I was referred to the hospital website to get necessary forms ahead of time *

I was placed on hold too long *

I was offered to be called back if needed *

I did not phone *

Your Impression of our Receptionist (Over the Phone):

Friendly and attentive *

Courteous *

Informative *

Your Impression of our Receptionist (In Person):

Stood and greeted me *

Aware of purpose of visit *

Seemed warm and cheerful *

Gave me undivided attention *

Seemed hospitable *

Answered all my questions *

Your Impression of our Reception Area:

Comfortable *

Neat & Clean *

Counter tops free from clutter *

Retail displays are well organized *

Odor-free *

Pet-friendly *

Your Impression of our Parking Lot/ Grounds:

Clean *

I found a parking spot with ease *

Your Impression of our Hospital Website

I visited the Pet Hospital Website *

I found the website to be helpful & resourceful *

I printed out any necessary forms ahead of time from the Hospital Website *

I registered to be a member and/ or to receive free newsletters *

Your Impression of our Technician:

Greeted me with warmth *

Was gentle with my pet *

Seemed proficient and knowledgeable *

Gave me the information I needed *

Pet-friendly *

Your Impression of our Veterinarian:

Introduced himself/ herself *

Washed his/her hands before examining my pet *

Listened to what I said & answered all my questions *

Gave clear advice about how to treat my pet *

Behaved professional in manner and appearance *

Answered all my questions *

Comforted me and my pet *

Made me feel valued *

Additional Questions:

Was your waiting time reasonable? *

Do you feel the fees were reasonable? *

Did you understand all our fees? *

Will you recommend us to others? Why or why not?

What suggestions do you have for improving the office, staff or procedures?

Client Experience Questionnaire Form

Client Experience Questionnaire Form

If you would like us to contact you, please fill out the necessary information.

CLIENT SURVEY

How Did You Choose our Hospital?

Your Telephone Experience:

Your Impression of our Receptionist (Over the Phone):

Your Impression of our Receptionist (In Person):

Your Impression of our Reception Area:

Your Impression of our Parking Lot/ Grounds:

Your Impression of our Hospital Website

Your Impression of our Technician:

Your Impression of our Veterinarian:

Additional Questions:

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