Bienville Veterinary Hospital Customer Satisfaction Survey

- Customer Satisfaction Survey -

Bienville Veterinary Hospital is committed to providing you and your pet with the highest quality of service and care. We always appreciate your feedback to let us know how we are doing. Please answer the following questions about your recent visit to Bienville Veterinary Hospital.

General Information:

Date of your visit:

What Veterinarian
did you see?

How did you hear
about us?

If other, please explain:

Was our office
easy to find?

Yes No

Was there
adequate parking?

Yes No

Bienville Veterinary Staff:

Did the receptionist
answer the phone in a timely and friendly manner?

Always Sometimes Never N/A

Did you have any problems scheduling an appointment with the preferred veterinarian?

Always Sometimes Never N/A

Was the front desk staff courteous & helpful

Always Sometimes Never N/A

Was there an excessive wait
to see the veterinarian?

Always Sometimes Never N/A

Was the veterinarian technician responsive to you
and your pet's needs?

Always Sometimes Never N/A

Did the veterinarian explain diagnosis, treatment, and follow-up instructions?

Always Sometimes Never N/A

Did the veterinarian
spend adequate time with
you and your pet?

Always Sometimes Never N/A

Overall Satisfaction:

Do you believe you received the highest quality of care and service from the staff of
Bienville Veterinary Hospital?

Always Sometimes Never N/A

Please rate your
overall experience at
Bienville Veterinary Hospital

Would you recommend Bienville Veterinary Hospital
to family, friends,
and/or co-workers

Always Sometimes Never N/A

Do you have any recommendations or comments?

Contact Information:

Please assist us by letting us know how we may contact you. Although this information is oprional, it would assist us in any follow-up action and allow us to respond to your needs!

Owner Information:

Last Name:

First Name:

Address:

Street:

City:

State:

Zip:

Telephone Number:

Email Address:

Pet’s Name:

Additional Comments:

Bienville Veterinary Hospital
4550 Springhill Avenue
Mobile, Alabama 36608
251-342-2885

Last revised: 19 June, 2007