Pedley Animal Hospital

Survey

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PEDLEY SURVEY

Please take a moment to complete our brief survey so that we can serve you better. Once the completed survey is submitted, you will be able to download and print a special coupon for Pedley Veterinary Hospital.

Please call our helpful staff at 951-685-5224 if you have further questions.

Pedley Veterinary Hospital Survey

Please fill out the survey form below accurately.

*Required

Client Name:

*Patient Name:

*Reason for Visit:

How did you choose our office

A friend or relative recommended the practice:

I saw the practice as I drove by:

I saw the practice ad in the Yellow Pages:

Other:

Upon arrival

Were you greeted?		Yes No

Atmosphere was pleasant:		Yes No

I had the attention of a staff member:		Yes No

Was the wait unreasonable?:		Yes No

When telephoning

My call was answered promptly:		Yes No

The staff member I spoke with was

Friendly and attentive:		Yes No

Concerned:		Yes No

Informative:		Yes No

Name of staff member I spoke to:

The technician

Introduced self:		Yes No

Was gentle and compassionate:		Yes No

Was proficient and knowledgeable:		Yes No

Had to many distractions:		Yes No

Pressured me into services:		Yes No

Technician's name:

The veterinarian

Introduced self:		Yes No

Described diagnosis and treatment:		Yes No

Answered all my questions:		Yes No

Were you given home care instructions?:		Yes No

Veterinarian's Name:

Appearance of the staff

Professional manner and appearance:		Yes No

Fees

Did you understand our fees?:		Yes No

Were you given an estimate?:		Yes No

Based on your experience, would you return?:		Yes No

Explain:

What suggestions do you have for improving the office, staff or procedures?: