The Humane Society of Utah Clinic Survey
1.

Reason for today's visit?
Vaccination(s)
Spay/Neuter
Schedule Spay/Neuter Appointment
Other  
2.

Were you acknowledged and greeted in a timely manner?
Yes
No
  • Comment:

  • 500 characters left.
3.

The name of the staff member who helped you?
 

  • 50 characters left.
4.

Were you treated in a professional, courteous, friendly manner?
Yes
No
  • Comment:

  • 500 characters left.
5.

Was our staff efficient?
Yes
No
6.
How would you rate your level of satisfaction with us?
Highly satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Highly dissatisfied
7.

How do we rate on the following attributes?
 Well Below Average Below Average Average Above Average Well Above Average 
Customer service
Professionalism
Cleanliness of Clinic facilities
  • Comment:

  • 500 characters left.
8.

How likely would you recommend us to a family/friend?
Very likely
Somewhat likely
Neutral
Somewhat unlikely
Very unlikely
9.

Would you use our services again?
Yes
No (If no, please explain below)
  • Comment:

  • 500 characters left.
10.

What brought you to this adoption location?
Comcast On Demand
Newspaper
Radio
Petfinder.com
Walk-In
Utah Jazz
Humane Society Website
TV News
Electronic billboards on I-15
Fox 13's "Best Friend" feature
Word of mouth
Salt Lake Bees
Off Site Adoptions (Outreach)
Phone Directory
Other  
11.

Do you have any suggestions?
 

  • 1000 characters left.
12.

What is your gender? (Optional)
Male
Female
Prefer not to answer
13.

Which category describes your age? (Optional)
Younger than 18
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
Prefer not to answer
14.

If you would like to be contacted please enter the information below with a Name, Phone and/or Email address.
 

  • 350 characters left.