We take your comments very seriously. Please take a few moments to fill out our questionnaire. Thank you.

1. Which practice did you visit? (If you visited more than one practice, please fill out a separate form for each practice.)

2. Who greeted you when you arrived?

3. Which of the following best describes the staff member who greeted you? (Check all that apply.)

4. How would you rate the quality of care your pet received from the technician?

5. How would you rate the quality of care your pet received from the veterinarian?

6. Which of the following best describes the technician? (Check all that apply.)

7. How long did you wait before you were seen by a veterinarian?

8. How would you rate the quality of care your pet received at our facility?

9a. Were you given instructions for further care of your pet’s problem?
(If no, skip to 10)

9b. If yes, were the instructions explained to you clearly?

10. How would you rate the appearance of the facility?

11. How would you rate the appearance of the staff?

12. How would you compare our facility with other veterinary practices you have visited?

13. If your pet should require specialty medical care in the future, would you return to Arizona Veterinary Specialists?

14. Would you recommend Arizona Veterinary Specialists to friends or relatives whose pets require specialty medical care?

15. If your pet should require emergency/critical care treatment in the future, would you return to the Emergency Animal Clinic?

16. Would you recommend the Emergency Animal Clinic to friends or relatives whose pets require emergency care?

17. How did you hear about the veterinary specialist or emergency veterinarian you came to see today?

18. If you were referred by your primary care veterinarian, do you feel the referral was made in a timely fashion?

19. What is the best way of informing you about veterinary specialty services?

20. What is the best way of informing you about emergency and critical care services?

Thank you! Your input is greatly appreciated.