Client Happiness Question Title * 1. When did you last visit our hospital? Within the last week One to four weeks ago One to three months ago Greater than 3 months ago Question Title * 2. How easy and pleasant was it to make the appointment? Very easy and pleasant Somewhat easy and pleasant Neutral Difficult or unpleasant Other (please specify) Question Title * 3. What was the purpose of your visit? Sick pet visit Wellness visit Picking up medication Picking up food Other (please specify) Question Title * 4. Were your concerns addressed to your satisfaction? Yes No Other (please specify) Question Title * 5. Did your appointment start early, late or on time? Early Late On time N/A Other (please specify) Question Title * 6. Which doctor did you see? Dr. Christensen Dr. Edwards Dr. Fisher Dr. Ward Dr. Wrycha Dr. Duyungan Dr. Scire Dr. Tweed N/A Question Title * 7. If not here for an appointment, were your needs attended to in a timely fashion? Yes No Other (please specify) Question Title * 8. How helpful and friendly was our reception staff? Very helpful and friendly Somewhat helpful and friendly Neutral Rude and/or unhelpful Other (please specify) Question Title * 9. How helpful and friendly was our exam room staff? Very helpful and friendly Somewhat helpful and friendly Neutral Rude and/or unhelpful Other (please specify) Question Title * 10. How helpful and friendly was your doctor? Very helpful and friendly Somewhat helpful and friendly Neutral Rude and/or unhelpful Other (please specify) Question Title * 11. What could we have done to improve your last visit? Question Title * 12. Would you like us to contact you in regard to this survey? Yes--please put name and phone/email below No Other (please specify) Done
