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Name
*
First
Last
What was the reason of your visit?
Please Select Option Below
Pet Emergency
Wellness Visit
Surgery
Dental Treatment
Change in Pet Behavior
Which doctor did you see?
How quickly did you get an appointment to see your veterinarian?
Same day
Next day
Same week
Following week
Did you get the appointment time you wanted?
Yes
No
How would you rate our front desk staff
Excellent
Pleasant
Efficient
Pre-occupied
Distracted
How long did you wait to see the doctor?
No wait
< 5mins
6-10 mins
11-15 mins
Over 16 mins
How effective was the doctor in explaining any issue and describing your options?
Excellent
Effective
Pleasant
Few Options
Poor
Did we adequately convey how much we care about you and your pet?
Yes
No
If no, can you explain what happened?
Please let us know your thoughts on how we might improve our service.
Would you like us to contact you to address your concern?
*
Yes, please.
No, thank you.
If yes, please give your name and contact information below
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What's Next
1
Call us
2
Meet with a doctor for an initial exam.
3
Put a plan together for your pet.
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