Pet DRx Survey
Required Required Question(s)
1.

Client Last Name, First Name, Pet(s) Name
 

  • 50 characters left.
Required 2.

Who was the primary DVM involved?
Dr. Kunz
Dr. Koodrich
Dr. Turek
Dr. Bohn
Relief
3.

Referral Source
How did you hear about us?
Road Sign
Phonebook
General Internet
Friend
None/Don't Remember
Petco
Palm Springs Animal Shelter
I don't remember--I've been coming here forever!
Other  
  • Comment:

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4.

General Attributes
(On a scale of 1-5, 5 being best)
How do we rate on the following general attributes?
 1 2 3 4 5 
Hospital cleanliness
Professionalism
Quality of veterinary care
Understanding customers' needs
Price (1 over priced, 3 reasonable, 5 under priced)
  • Comment:

  • 500 characters left.
5.

Overall Satisfaction
(On a scale of 1-5, 5 being best)
How would you rate your overall level of satisfaction with us?
1 2 3 4 5       
      
  • Comment:

  • 500 characters left.
6.

Appointment Scheduling
(On a scale of 1-5, 5 being best)
When you made your appointment was the staff courteous/helpful?
1 2 3 4 5       
      
  • Comment:

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7.

Appointment Availability
Did you recieve the appointment time you desired?
First Choice
Second Choice
Third Choice
No
  • Comment:

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8.

Arrival/Check-in
Did the staff greet you when you arrived?
YES
NO
  • Comment:

  • 500 characters left.
9.

Wait Time
Did your appointment start on time?
YES
NO
  • Comment:

  • 500 characters left.
10.

Examination and Treatment
Did the doctor address the reason for your visit to your FULL satisfaction?
YES
NO
  • Comment:

  • 500 characters left.
11.

Bedside Manner
(On a scale of 1-5, 5 being best)
How would you rate the doctor's bedside manner?
1 2 3 4 5       
      
  • Comment:

  • 500 characters left.
12.

Estimate Presentation
Were you provided with an appropriate estimate for services prior to services being performed?
Estimate was LOW
Estimate was ACCURATE
Estimate was HIGH
No Estimate Provided
No Estimate Needed
The Estimate Process was Poor
  • Comment:

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13.

Estimate Presentation
Who presented the estimate?
Front Office Staff
Exam Room Assistant
Veterinarian
Don't Know
No Estimate Provided
No Estimate Needed
  • Comment:

  • 500 characters left.
14.

Nursing Staff
(On a scale of 1-5, 5 being best)
How well did the nursing staff serve you and your pet?
1 2 3 4 5       
      
  • Comment:

  • 500 characters left.
15.

Staff Appearance
(On a scale of 1-5, 5 being best)
Did the staff have a professional appearance?
1 2 3 4 5       
      
  • Comment:

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16.

The Final Bill
Did the final bill match the estimate?
Not Even Close NO YES Better Than Expected No Estimate Provided       
      
  • Comment:

  • 500 characters left.
17.

How likely is it that you would recommend our hospital to a friend or colleague?
Very likely
Somewhat likely
Neutral
Somewhat unlikely
Very unlikely
18.

Do you have any suggestions for improving our veterinary care?
 

  • 350 characters left.