Form - Client Survey

How would you rate your overall experience with Hebron Cat Hospital and Toy Dogs? (required)
5 star service
4 star service
3 star service
2 star service
1 star service

Were you greeted promptly upon your arrival in the lobby? (required)
yes
no

Was the person who greeted you friendly and welcoming? (required)
yes
no

If you waited in the lobby/exam room, approximately how long did you wait after your arrival? (required)
did not wait
1-5 minutes
6-10 minutes
11-15 minutes
don't remember

Once in an exam room, how long did you wait, after seeing the assistant, before seeing a doctor? (required)
did not wait
5-10 minutes
11-20 minutes
20-30 minutes
don't remember

How would you rate our staff on...
making you feel comfortable and informed on your pet's status? (required)
very comfortable
comfortable
uncomfortable
very uncomfortable

being friendly and easy to understand? (required)
excellent job
good job
mediocre job
poor job

being knowledgeable about your pet's condition? (required)
very knowledgeable
knowledgeable
not knowledgeable
unsure

the overall treatment and handling of your pet? (required)
very gentle and confident treatment
satisfactory treatment
hestitant/unsure treatment
unsatisfactory treatment

Overall experience
How likely are you to recommend Hebron Cat Hospital and Toy Dogs to a friend or relative? (required)
very likely
likely
unlikely
very unlikely

Would you come back to us for your pet's next veterinary visit? (required)
I definitely will come back
I may come back
I will not come back

How would you rate your relationship with us, considering all of your experiences with us? (required)
Excellent
Very Good
Good
Fair
Poor

Please tell us what you liked most about your visit:

Please tell us what we could improve on for your next visit:

If this was your first visit, why did you choose us? (check all that apply)
personal reference
close to work/home
driving by
search engine
door hanger
magazine ad
newspaper ad
open house
event booth
other (please list below)
If you listed "other," why did you choose us?

Your Information (Optional, but required for $5 credit)
Name
First Name
Last Name
E-Mail Address :
Do we have your permission to add this information to our testimonial page? (required)
yes (first name and last initial)
yes, without my name
no, thank you


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