Client Satisfaction
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1. Clients Satisfaction Survey

1. How were you referred to our office?

How were you referred to our office? Friend

Neighbor

Yellow Pages

Internet (please specify source below)

Drove By

Other (please specify)

2. Please rate our facility accommodations.

	Stongly Disagree	Disagree	Agree	Strongly Agree	N/A
Parking lot was clean	*Please rate our facility accommodations. Parking lot was clean Stongly Disagree	Parking lot was clean Disagree	Parking lot was clean Agree	Parking lot was clean Strongly Agree	Parking lot was clean N/A
Parking was adequate	Parking was adequate Stongly Disagree	Parking was adequate Disagree	Parking was adequate Agree	Parking was adequate Strongly Agree	Parking was adequate N/A

Other (please specify)

3. Please tell us about our waiting room.

	Stongly Disagree	Disagree	Agree	Strongly Agree
Waiting room was comfortable	*Please tell us about our waiting room. Waiting room was comfortable Stongly Disagree	Waiting room was comfortable Disagree	Waiting room was comfortable Agree	Waiting room was comfortable Strongly Agree
Waiting room was clean	Waiting room was clean Stongly Disagree	Waiting room was clean Disagree	Waiting room was clean Agree	Waiting room was clean Strongly Agree
Location is convenient	Location is convenient Stongly Disagree	Location is convenient Disagree	Location is convenient Agree	Location is convenient Strongly Agree
Facility was odor free	Facility was odor free Stongly Disagree	Facility was odor free Disagree	Facility was odor free Agree	Facility was odor free Strongly Agree

Other (please specify)

4. Our office hours are...

Our office hours are... Convenient

Restrictive

Should have more available hours

Accommodating to my needs

Suggestions:

5. Please tell us about our reception staff.

	Stongly Disagree	Disagree	Agree	Strongly Agree	N/A
Receptionist were welcoming / hospitable	*Please tell us about our reception staff. Receptionist were welcoming / hospitable Stongly Disagree	Receptionist were welcoming / hospitable Disagree	Receptionist were welcoming / hospitable Agree	Receptionist were welcoming / hospitable Strongly Agree	Receptionist were welcoming / hospitable N/A
Greeted me promptly	Greeted me promptly Stongly Disagree	Greeted me promptly Disagree	Greeted me promptly Agree	Greeted me promptly Strongly Agree	Greeted me promptly N/A
Were professional	Were professional Stongly Disagree	Were professional Disagree	Were professional Agree	Were professional Strongly Agree	Were professional N/A
Were Helpful and knowledgeable	Were Helpful and knowledgeable Stongly Disagree	Were Helpful and knowledgeable Disagree	Were Helpful and knowledgeable Agree	Were Helpful and knowledgeable Strongly Agree	Were Helpful and knowledgeable N/A

Other (please specify)

6. When you telephoned...

When you telephoned... Your call was answered promptly

There was a long wait before someone answered

You were placed on hold too long

Other (please specify)

7. Was your phone conversation...

Was your phone conversation... Courteous

Hurried

Impolite

Informative

Preoccupied

I did not Phone

Other (please specify)

8. Please tell us about our technical staff.

	Stongly Disagree	Disagree	Agree	Strongly Agree	N/A
Was Gentle and Caring	*Please tell us about our technical staff. Was Gentle and Caring Stongly Disagree	Was Gentle and Caring Disagree	Was Gentle and Caring Agree	Was Gentle and Caring Strongly Agree	Was Gentle and Caring N/A
Was knowledgeable	Was knowledgeable Stongly Disagree	Was knowledgeable Disagree	Was knowledgeable Agree	Was knowledgeable Strongly Agree	Was knowledgeable N/A
Was attentive to my pet's needs	Was attentive to my pet's needs Stongly Disagree	Was attentive to my pet's needs Disagree	Was attentive to my pet's needs Agree	Was attentive to my pet's needs Strongly Agree	Was attentive to my pet's needs N/A

Other (please specify)

9. Please tell us about your pet's veterinarian.

	Stongly Disagree	Disagree	Agree	Strongly Agree
Listened to and addressed my concerns	*Please tell us about your pet's veterinarian. Listened to and addressed my concerns Stongly Disagree	Listened to and addressed my concerns Disagree	Listened to and addressed my concerns Agree	Listened to and addressed my concerns Strongly Agree
Expressed compassion	Expressed compassion Stongly Disagree	Expressed compassion Disagree	Expressed compassion Agree	Expressed compassion Strongly Agree
Had a good bedside manner	Had a good bedside manner Stongly Disagree	Had a good bedside manner Disagree	Had a good bedside manner Agree	Had a good bedside manner Strongly Agree
Made clear treatment recomendations	Made clear treatment recomendations Stongly Disagree	Made clear treatment recomendations Disagree	Made clear treatment recomendations Agree	Made clear treatment recomendations Strongly Agree
Portrayed a professional appearance	Portrayed a professional appearance Stongly Disagree	Portrayed a professional appearance Disagree	Portrayed a professional appearance Agree	Portrayed a professional appearance Strongly Agree

Other (please specify)

10. Please rate the following...

	Stongly Disagree	Disagree	Agree	Strongly Agree	N/A
I felt the wait Time was reasonable	*Please rate the following... I felt the wait Time was reasonable Stongly Disagree	I felt the wait Time was reasonable Disagree	I felt the wait Time was reasonable Agree	I felt the wait Time was reasonable Strongly Agree	I felt the wait Time was reasonable N/A
I felt that the fees reflected the value of care	I felt that the fees reflected the value of care Stongly Disagree	I felt that the fees reflected the value of care Disagree	I felt that the fees reflected the value of care Agree	I felt that the fees reflected the value of care Strongly Agree	I felt that the fees reflected the value of care N/A
I am likely to return for care	I am likely to return for care Stongly Disagree	I am likely to return for care Disagree	I am likely to return for care Agree	I am likely to return for care Strongly Agree	I am likely to return for care N/A
I am likely to recommend CAH to others	I am likely to recommend CAH to others Stongly Disagree	I am likely to recommend CAH to others Disagree	I am likely to recommend CAH to others Agree	I am likely to recommend CAH to others Strongly Agree	I am likely to recommend CAH to others N/A

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Client SatisfactionExit this survey

1. Clients Satisfaction Survey

1. How were you referred to our office?

2. Please rate our facility accommodations.

3. Please tell us about our waiting room.

4. Our office hours are...

5. Please tell us about our reception staff.

6. When you telephoned...

7. Was your phone conversation...

8. Please tell us about our technical staff.

9. Please tell us about your pet's veterinarian.

10. Please rate the following...

Client Satisfaction
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