Kenosha Animal Hospital

6223 39th Avenue
Kenosha, WI 53142

(262)658-3533

kenoshaanimalhospital.com

Client Satisfaction Survey Form

Name (required)
First Name (required)
Last Name (required)
Pet's Name (required)

Phone (required)
Phone TypePhone Number (required)
How efficient and courteous was the person who answered your call?
Excellent
Good
Unsatisfactory


E-Mail Address (required) :
Was your call answered in a prompt and timely manner?
Yes
No


How were you treated by the technician while waiting in the room?
Excellent
Good
Satisfactory


Were you given all necessary information including medication & instructions?
Yes
No


If NO, please explain:

Did your appointment begin promptly?
Yes
No


How long was your wait before you were seen by the vet?
No waiting
5-15 Minutes
Longer than 15 Minutes


Was the veterinarian attentive and listen closely to what you explained?
Yes
No


Were problems and treatments explained clearly?
Yes
No


Did the veterinarian seem genuinely concerned about your pet?
Yes
No


Was our facility exceptionally clean, comfortable and free of any odors during your visit?
Excellent
Good
Fair
Poor


If your pet was hospitalized, was the duration of their stay reasonable for the injury/illness?
Yes
No


Do our hours of operation meet all of the needs as a client?
Yes
No


Are the services reasonably priced?
Yes
No


Would you recommend this hospital to others?
Yes
No


While visiting Kenosha Animal Hospital, was there anyone who made your visit stand out?
Yes
No


If YES, who? Please explain:

Was there anyone who made your visit uncomfortable or did not meet your expectations?
Yes
No


If YES, who? Please explain:

Please add any additional comments or suggestions in the space provided:

How were you referred to our office?
Friend
Neighbor
Drove By
Yellow Pages
Web Site
Google/Search Engine
Facebook
Family Member
Other



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