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How would you rate our concern for you & your pet’s privacy? *
How often have you visited Clermont Animal Hospital, Inc. Hospital within the past year? *
Did you schedule an appointment by phone or did you drop in? *
If you scheduled an appointment, did you have to wait longer than expected? * Yes No
How easy was it to make an appointment by telephone? *
Was the person who scheduled your appointment courteous and helpful? *
How would you rate the courtesy of the staff at the reception desk? *
How long did you wait in the reception area beyond your scheduled appointment time? *
Did the support staff member clearly identify themselves & their qualifications? * Yes No
How would you rate the competence of the technician/assistant who helped you? *
How would characterize the concern that the technician/assistant showed? *
Did the technician/assistant respond to your requests within a reasonable period? * Yes No
How would you rate the professionalism and competence of the technician/assistant? *
Were you able to see the veterinarian of your choice? * Yes No
Did you feel that your veterinarian spent an adequate amount of time with you? * Yes No
How would you characterize the demeanor of your veterinarian: *
How would you rate the competence of your veterinarian? *
Did you feel that your veterinarian’s examination was thorough? * Yes No
Please rate the clarity of the veterinarian’s explanation of your pet’s condition & treatment options: *
How well did your veterinarian include you in healthcare decisions? *
Were your questions answered to your satisfaction? * Yes No
Would you recommend this facility and its staff to your family and friends? * Yes No
Have you visited our website before today? * Yes No
Would you be interested in receiving a newsletter if we start offering it? * Yes No
Would you be interested in receiving email reminders for your pets vaccinations if it were offered? * Yes No
If yes, Please include your e-mail address. *
Do you have any comments or suggestions that you feel might help us to improve for you and your pets? *
Would you like someone to contact you regarding your responses on this survey? * Yes No

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Clermont Animal Hospital 2011