EMERGENCY VETERINARY CLINIC SURVEY Please help us better meet the needs of you and your pet by completing the following quesions about your recent visit to the EVC. Please respond to the following with: 1 = Poor and 5 = Excellent

Date Seen	*
Seen by Dr.	*
The Hospital appearance		- Select - 1 2 3 4 5
The appearance/presentation of the Doctors and staff		- Select - 1 2 3 4 5
The Hospital staff was courteous, concerned, knowledgable and professional		- Select - 1 2 3 4 5
The quality of care was relative to the amount of the bill		- Select - 1 2 3 4 5
The Veterinarian was compassionate		- Select - 1 2 3 4 5
The Veterinarian's instructions were clear, easily understood, and my questions were answered to my satisfaction		- Select - 1 2 3 4 5
Overall satisfaction with this visit		- Select - 1 2 3 4 5
Please share any comments or concerns you feel may help us:
If you would like to be contacted about a problem or concern, please give us your name and a number where you may be reached: