Customer Satisfaction Survey
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1. Default Section
1
. Contact Details(Optional):
Contact Details(Optional):
Name:
Contact Number:
Email Address:
Pet Name/s:
2
. How did you find out about our Clinic?
Referral
How did you find out about our Clinic?
White Pages
Yellow Pages
Yellow Pages Online
Signage/Driving past
Word of mouth/ Friend
Kalbarri Clinic
Website
Community Directory Kalbarri
Community Directory Geraldton
Other
How did you find out about our Clinic? How did you find out about our Clinic? Referral
Other (Please specify)
3
. Staff who served you (Optional):
Staff who served you (Optional):
4
. Approximate date of your last visit to our clinic:
Approximate date of your last visit to our clinic:
5
. How did you feel about the level of customer service you receive when you last visited our Practice?
How did you feel about the level of customer service you receive when you last visited our Practice?
6
. What did you like most about your visit to our practice?
What did you like most about your visit to our practice?
7
. In what area/s could we improve?
In what area/s could we improve?
8
. Are there any services that you require which we do not currently offer?
Are there any services that you require which we do not currently offer?
9
. How did you feel about the price you paid compared to the products/services you received?
How did you feel about the price you paid compared to the products/services you received?
Cheap
Reasonable
Good value for money
Expensive
Other (please specify)
10
. Would you refer our Practice to a Family member or Friend?
Would you refer our Practice to a Family member or Friend?
Yes
No
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