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Home
Client Comment Survey
How did you hear about the Animal Emergency Center?:
Your veterinarian
Your veterinarian’s answering machine
Yellow Pages
Been here before
Radio Advertisement
Television
Referred by a friend
Internet/Website
Movie Theater
Billboard
Other
If Other:
Which specialty service were you here seeing?:
Emergency / Critical Care
Oncology
Surgery
Rehabilitation
Internal Medicine
Exotic Pets
Imaging
Dentistry / Oral Surgery
Dermatology
AEC South
When you telephoned:
Your call was answered promptly
There was a long wait for someone to answer
You were placed on hold too long
Made you feel like a valued client
I did not phone
Your phone conversation was:
Courteous
Hurried
Impolite
Informative
Our receptionist(s):
Greeted you promptly
Was warm and caring
Gave their undivided attention
Seemed indifferent
Was informative
Our technician(s):
Greeted you warmly
Was gentle with your pet
Seemed proficient
Was knowledgeable/informative
Was unable to adequately communicate your concerns to the veterinarian
Had a positive attitude
Made you feel like a valued client
The Veterinarian:
Introduced him/herself with a warm greeting
Listened well to your pet’s present symptoms
Seemed in a hurry
Described the diagnosis and treatment well
Offered treatment options within my financial means
Left me confused about how to treat my pet
Was good at comforting me and my pet
Answered my questions thoroughly
Made me feel like a valued client
You were given an estimate of charges for any treatment your pet received
While you were waiting to be seen:
You understood patients are seen in order of medical priority
Your waiting time was reasonable
Your waiting time was unreasonable
You were offered a treat by the receptionist
When you paid your bill:
Payment policy was clearly communicated to you
Your processing time was reasonable
Paid with a Credit Card
Paid with cash
Paid with a check
Paid with CareCredit
Would you return based on your experience?:
Yes
No
Would you recommend us to others?:
Yes
No
What suggestions or comments would you have for improving the office, staff, or procedures?:
First Name:
Last Name:
Address1:
City:
State:
...
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zipcode:
Who is your Primary Care Vetrinarian
(Name, Hospital, and City):
E-Mail:
We hate Spam as much as you do (unsolicited commercial e-mail).
Your e-mail address will not be given out. It's that simple.
Would you like to receive an occasional e-mail or mailing from this clinic?
(Helpful information, clinic newsletter, service reminders for your pet, etc.):
Yes
No
2100 W. Silver Spring Drive | Glendale, WI 53209 | 1.414.540.6710 |
© 200
8 Animal Emergency Center