Veterinarian Survey Template

Patient expierence at a Veterinarian's office, including quality of care, costs, and likelihood to visit again.



   
 
Hello:
Please take a few minutes to fill out this survey on how our facility has responded to your needs as well as those of your pet. We value your feedback and your responses will be used in making your future experience better. Thank you for your input.

 
 
   
 
1. What is the name of your pet?
   
 
   
 
2. What is the species of your pet?
   
 
   
 
3. How did you learn about our hospital?
 
My primary care veterinarian referred me
 
Internet
 
Referred by a friend or family member
 
From yellow pages
 
Others
 
   
 
4. Please indicate the reason for your visit?
 
Regular checkup
 
Pet accident or emergency
 
Sick pet
 
Specialist
 
Other
 
   
 
5. Did you feel that the doctor understood and addressed the needs of your pet?
 
Yes
 
No
 
   
 
6. Did you feel that the doctor explained in a clear way the pets’ condition, treatment method, and how to administer medication as well as follow up care?
 
Yes
 
No
 
N/A
 
   
 
7. How satisfied are you with the hospital cleanliness and appearance?
 
Very Satisfied
 
Somewhat Satisfied
 
Neutral
 
Somewhat Unsatisfied
 
Very Unsatisfied
 
   
 
8. How satisfied are you with the cost of service for the value you and your pet have received?
 
Very Satisfied
 
Somewhat Satisfied
 
Neutral
 
Somewhat Unsatisfied
 
Very Unsatisfied
 
   
 
9. How likely are you to revisit our hospital for veterinary care?
 
Definitely will revisit
 
Will likely revisit
 
Neutral
 
Likely won’t revisit
 
Definitely won’t revisit
 
   
 
10. How likely is it that you will recommend our facility to other pet owners?
 
Definitely will recommend
 
Likely will recommend
 
Neutral
 
Unlikely will recommend
 
Not at all likely to recommend
 

Health Care Surveys

Medical Examination Services Survey Template

21 questions

Medical Service Evaluation survey for desirability of medical examination features, and customer attitudes of current services.

Health Care Surveys

Healthcare Opinion Survey Template

44 questions

Hospital and health care opinion survey about the quality, affordability, availability, and preferences of customers.

Health Care Surveys

Physician Practices Survey Template

47 questions

Physician practices survey, providing an evaluation of hospital and services provided.

Complex insights made simple. Get Started for FREE