Barlow Trail Veterinary Clinic Client Satisfaction Form

We would like to know how your feel about the services we provide so we can make sure we are meeting your needs. Your responses are very helpful as we endeavor to improve these services. Your survey will be forwarded to our Office Supervisor. After completeting the survey, click "SUBMIT".

Thank you for your time.

Your Name

Your Pet's Name

Your Pet's Breed

Approximate date of your last visit

What services did you have performed?

Your e-mail address

Please check the box with the corresponding number according to how well
you think we are doing in the following areas.

GREAT: 5 GOOD: 4 SATISFACTORY: 3 FAIR: 2 POOR: 1

Ease of getting care for your pet:

Ability to get an appointment:

5

4

3

2

1

Hours clinic is open:

5

4

3

2

1

Waiting time:

Time in waiting room:

5

4

3

2

1

Time in exam room:

5

4

3

2

1

Veterinarian:

Takes enough time with you and your pet:

5

4

3

2

1

Answers all your questions completely:

5

4

3

2

1

Veterinary Technicians and Assistants:

Friendly and helpful to you:

5

4

3

2

1

Answers your questions:

5

4

3

2

1

Reception Staff:

Friendly and helpful to you:

5

4

3

2

1

Answers your questions:

5

4

3

2

1

Your experience:

How likely would you be to refer your friends and relatives to us?

Definitely

Probably

Maybe

Never

Did any particular Veterinary Technician or Assistant
provide exceptional care during your visit?

What did you like best about our clinic?

What did you like least about our clinic?

Suggestions for improvement?

Thank you for completing our survey!
Please click on "SUBMIT" below.

* Indicates Response Required