General Patient Information

How often have you visited our practice within the past year?

If this is your first visit, how did you find out about us?

Scheduling Your Appointment

How easy was it to make an appointment by telephone?

If you scheduled an appointment, did you have to wait longer than expected?

Was the person who scheduled your appointment courteous and helpful?

Day of Your Appointment

How would you rate the courtesy of the staff at the reception desk?

How long did you wait in the reception area beyond your scheduled appointment time?

How long did you wait in the exam room before the veterinarian appeared?

The Medical Support Staff

Did the support staff member clearly identify themselves?

How would you characterize the concern that the technician/assistant showed?

How would you rate the professionalism and competence of the technician/assistant?

The Doctor

Were you able to see the veterinarian of your choice?

Did you feel that your veterinarian spent an adequate amount of time with you?

How would you characterize the concern that the veterinarian showed?

How would you rate the competence of your veterinarian?

Additional Feedback