Bradshaw Mountain Animal Hospital / Satisfaction Survey Web Form

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Animal Hospital

Form - Satisfaction Survey Web Form

Do you plan to continue bringing your pet(s) to Bradshaw Mountain Animal Hospital?
Yes
No

If No, please share your reason for leaving.
(chose all that apply)
Moved
Service problem
Did not like doctor
Cost of care
Did not see the same doctor each visit
Other

If Other please explain your reason for not returning.

What services did your pet receive during your visit to Bradshaw Mountain Animal Hospital?
Exam & vaccine
Sick pet/emergency
Recheck exam
Treatment
Dentistry,surgery, or hospitalization
Purchaseing medication or product
Grooming

Were you able to schedule an appointment that fit your shedule?
Yes
No

Did the hospital service representative greet yo in a helpful and friendly manner?
Yes
No

Did the receptionist inform you of which doctor you would see durning you visit?
Yes
No

Did you request to see a specific doctor?
Yes
No

If no, did the receptionist ask if you had a doctor preference?
Yes
No

Which doctor did you see during your visit?
Dr. Walker
Dr. Laucher
Dr. Bliss-Love
Dr. Coffer
Not sure

Was the veterinarian courteous and genuinely concerned with your pet's health?
Yes
No

Did the veterinarian explain your pet's health or illness clearly and completely?
Yes
No

Do you feel that your pet received quality professional care?
Yes
No

If No, can you please explain your reasoning?

If your pet had surgery or was hospitalized, did you receive adequate home-care instructions?
Yes
No

Would you recommend Bradshaw Mountain Animal Hospital to your friends?
Yes
No

If No, why?

How would you rate the overall level of service at our hospital?
Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied

How could we improve out hospital's service?

If you could change anything about Bradshaw Mountain Animal Hospital, what would it be?

Any additional comments?

If you would like us to contact you regarding this survey please provied the following information.

Name
First Name	Last Name

Phone
Phone Type	Phone Number

E-Mail Address :

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