Thank you for giving us the opportunity to serve you. Please help us better meet your needs by taking a moment to complete this questionnaire. As you answer the questions think about your experience on this visit only.
Date of Service:
Veterinarian: Dr. Frank Mondi Dr. Mark Chmielewicz Dr. Greg Jamrosz Dr. David Nickel Dr. Maria Arnsman
1. My call was answered promptly. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
2. The receptionist was courteous and helpful on the telephone. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
3. I was greeted upon arrival. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
4. The front desk staff was efficient, friendly and concerned about my pet. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
5. The admitting technician was friendly and concerned about my pet. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
6. The technical staff was helpful, knowledgeable and explained things clearly. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
7. The veterinarian was courteous and compassionate. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
8. The veterinarian explained things clearly and completely. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
9. I feel my pet received quality, professional health care. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
10. My bill or estimate was presented in adequate detail. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
11. I was satisfied with the amount of time I waited for my appointment. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
12. I was satisfied with my overall experience. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
13. I would recommend your veterinary practice to my friends and family. Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
If your pet was hospitalized, please answer the following additional questions:
14. The length of time my pet needed to stay in the hospital seemed reasonable. Not Applicable Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
15. My pet was returned to me in good, clean condition. Not Applicable Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
If your pet was boarded or groomed, please answer the following additional questions:
16. The Care Center staff was efficient, friendly and concerned about my pet. Not Applicable Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
17. My pet was returned to me in good, clean condition. Not Applicable Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
18. I was pleased with my pet’s overall boarding/grooming experience. Not Applicable Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree
Would you like to see any of the following services offered:
19. More evening hours: YES NO NO OPINION
20. Until what time in the evening:
21. Pet transportation to and from our facility YES NO NO OPINION
22. Longer hours on Saturday YES NO NO OPINION
23. Mobile veterinary services YES NO NO OPINION
24. Please use this space for additional comments:
25. I would like to be contacted regarding a problem or concern. NO YES
Name:
Pet:
Email:
Phone:
Best time to reach me is:
Thank you for your participation