House Call Survey
 

1. House Call and Mobile Practice Survey

 
Please fill out if you have had a house call or mobile practice for 6 months or longer.
Your replies are individually anonymous.
After you contribute your replies, you may enter your contact information at the end, if you would like to have us send you the compiled results.
Please tell others about this survey so we may gather useful data. Thank you!
(If you are not eligible to complete the survey and are interested in the results, please email separately to carin@smithvet.com)

1. Which best describes you?

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2. Please check the description most closely matching your vehicle.

*
3. Your practice is best described as:

4. Please provide the following data

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5. With regard to your house call (trip) fee, do you (fill out any/all that apply; do not include your exam fee)

*
6. With regard to your exam fee, do you

7. If you have an arrangement with one or more practices to work on your patients at their facility, do you

8. Check all the procedures that you routinely perform (do not include procedures done at a practice)

9. What computer software program(s) do you use?

*
10. Which of the following people do you pay to assist you?

 Part-timeFull-time
None
Household help
Office help
Phone service
General assistant (performs technician & receptionist/office duties)
Technician assistant
Credentialed technician

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11. How long have you

 0-1 yr2-5 yr6-15 yr>15 yr
been a veterinarian?
been a house call or mobile veterinarian?

12. Please add any comments or explanations here.

13. Optional: Enter your name, E-mail address, and phone number
and note:
If you would like to be notified about the results of this survey and/or
If we may contact you for additional information.
Thanks!