Client Feedback

We are committed to providing the highest level of care to you and your pet. In order to so, we’d like to get your feedback and continue to improve. Please take a few moments to read and respond to the following survey.

Which VERC service did you use? (Select all that apply. Required.)
Emergency + Critical Care
Internal Medicine
Radiology/Ultrasound
Surgery

How did you hear about VERC? (Select all that apply.)
Referral
Website
Yellow Pages
Friend
Street Sign
Advertisement
Other

If from advertisement, where?

The reception staff was kind and courteous. (Choose one.)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

The intake form and process was clear and easy to complete. (Choose one.)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

The wait to see the veterinarian was reasonable. (Choose one.)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

The staff clearly communicated with me regarding my pet's prognosis and care. (Choose one.)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

The staff was accessible for questions after I went home. (Choose one.)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

My pet received high quality care at VERC. (Choose one.)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

Was there a staff member who was particularly helpful? (Choose one.)
Yes
No

If yes, who?

I would return or refer a friend to VERC. (Choose one.)
Yes
No

If no, why?

The waiting area and exam room was clean and comfortable. (Choose one.)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Other

If you selected other, please explain.

Other comments/suggestions for improvement?

Suggestions

Your Family Veterinarian

Date of Visit

Pet's Name

Your Name

Email