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Thank you for placing your pet's
health concerns in our hands. We value your
trust and our two main goals are to provide the
best care possible for your pet and to make
your visit an enjoyable one with friendly
service. However, we need your help to
make sure that we are meeting or exceeding your
needs and expectations.
Please take a few minutes to complete
our online survey so that we may constantly
improve our services for you and your
pets. Your feedback is the only way we
can find out about things we are doing well (we
all need a pat on the back every now and then)
and things we didn't do so well (how can we fix
the problem if good people like you don't let
us know that we have a problem?!). So whether
you had an awesome experience with us or an
experience that did not meet your expectations,
please let us know. |
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First Name |
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| *Last Name |
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| *Email Address |
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| *Telephone Number |
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| *One of your pets' names |
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| *Approximate date of your last
visit |
(Use this
format: 01/01/2006) |
| *May
we call you back to follow up with any of your
concerns? |
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| Comfortable |
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| Neat
and clean |
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| Odor-free |
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| My
call was answered promptly |
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| It
was easy to make an appointment |
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| I
received a convenient appointment |
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| The
Receptionist answered all of my
questions |
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| The
Receptionist was polite |
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| Smiled and greeted me |
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| Was
polite and friendly |
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| Verified my name, my pet's name and why
I was here |
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| Informed me if the doctor was way behind
schedule |
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| Went
over the invoice with me and gave me a
receipt |
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| Offered to help me carry food or help
with my pet out to my car (if needed) |
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| On a
scale of 1-5 with 1 being poor, 3 being average
and 5 being excellent, how would you rate our
receptionists? |
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| If
you answered something other than 4 or 5, please
let us know what went wrong: |
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| Smiled and greeted me |
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| Was
polite and friendly |
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| Verified why I came in and the services
desired |
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| Answered any questions I had |
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On a scale of 1-5
with 1 being poor, 3 being average and 5 being
excellent, how would you rate your experience
with the Exam Room Assistant? |
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| If
you answered something other than 4 or 5, please
let us know what went wrong: |
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| Who
did you see? |
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| Smiled and greeted me |
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| Was
polite and friendly |
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| Verified why I came in and the services
desired |
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| Has a
good bedside manner |
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| Explained the physical examination
clearly |
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| Discussed any problem areas in
detail |
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| Answered any questions I had |
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| Provided a Summary of Treatment
Recommendations (Estimate) for a recommended
surgery/dental or other recommended medical
treatment |
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On a scale of 1-5
with 1 being poor, 3 being average and 5 being
excellent, how would you rate your experience
with your Doctor? |
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| If
you answered something other than 4 or 5, please
let us know what went wrong: |
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We value your time.
One of our main goals is to work as quickly as
possible while giving each of our clients the
full attention they deserve. Due to the nature
of healthcare (emergencies, traffic causing
clients not to arrive on time, unexpected
problems discovered during examination,
etc...), most delays are beyond our control.
But, we want you to be happy and for your wait
to be reasonable. What did you experience
during your visit?
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| Amount of time before a Receptionist
acknowledged me and checked me in |
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| Time
waited until I first saw an Exam Room
Assistant |
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| Time
waited until I first saw the Doctor |
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| Length of visit with Doctor in exam
room |
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| Time
waited after Doctor finished until
check-out |
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| Time
it took to pay and go over invoice
(check-out) |
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| Is
there anyone at our hospital who provided you
with exceptionally good OR really poor service?
If so, please give us a little information so we
can pat them on the back or kick them in the
pants! |
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| Would
you recommend our hospital to others? |
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| Were
you satisfied with the value of services received
during your visit? |
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| On a
scale of 1-5 with 1 being poor, 3 being average
and 5 being excellent, what is your overall
opinion of Oak Hills Animal Hospital? |
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| Other
comments and is there anything we can do to
improve your next visit: |
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| Please be sure to hit the Submit button
below (just once) to send us the form. Thank you
for your time and interest in helping us improve
Oak Hills Animal Hospital! |