Forms : Feedback

Rock Bridge Animal Hospital Survey

 

Thank you for placing your pet's health concerns in our hands.  We aim to give your pets the best care while making sure you have an enjoyable, friendly and educational visit with us.  In order to keep doing that, we need to know how we are doing, if we are meeting your expectations and needs.  Please take a few moments to complete our survey. All personal information submitted will be confidential. Your responses will be used to help us create a great experience for you and your pets.

 

    

Form - Feedback Form

Using the following scale, please rate your level of satisfaction:
  1. Very dissatisfied
  2. Somewhat dissatisfied
  3. Satisfied
  4. More than satisfied
  5. Extremely satisfied

When calling to schedule an appointment was your call answered in a friendly and timely manner?
1
2
3
4
5

Was the hospital sanitary, neat and clean? (odor free)
1
2
3
4
5

Were you and your pet greeted promptly and in a friendly manner by the receptionist upon arrival?
1
2
3
4
5

Was the waiting time reasonable?
1
2
3
4
5

Was the veterinary assistant helpful and informative?
1
2
3
4
5

Was your pet handled in a gentle and caring manner?
1
2
3
4
5

Did the doctor explain the procedure or treatment being performed on your pet to your satisfaction?
1
2
3
4
5

Did the doctor clearly provide enough information regarding any medical conditions and diagnosis?
1
2
3
4
5

Were your questions answered to your satisfaction?
1
2
3
4
5

Do you feel the charges were consistent with the services provided?
1
2
3
4
5

Would you refer a friend or family member to our hospital?
1
2
3
4
5

What do you think of our website? Is there anything else you would like to see on our website?

Additional questions or comments:

Name (optional)
First Name
Last Name
Address (optional)
Street Address
City
State/Province
Zip/Postal Code
,
Phone (optional)
Phone TypePhone Number
E-Mail Address (optional) :
Can we contact you regarding your survey comments? (If so, please provide contact information)
Yes
No

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