EMERGENCY VETERINARY CLINIC SURVEY The Peninsula Veterinary Associates take your comments seriously. Please help us better meet the needs of you and your pet by completing the following questions about your recent visit to the PEVC.

Date Seen	*
Seen by Dr.	*
Who greeted you when you arrived?		- Select - Receptionist Technician Veterinarian Staff Member - not sure of role
Which of the following best describes the staff member who greeted you? (Check all that apply).		Helpful Indifferent Rude Warm Caring Professional Not Professional
Which of the following best describes the technician or assistant? (Check all that apply).		Helpful Indifferent Rude Warm Caring Professional Not Professional
How would you rate the quality of care your pet received from the technician or assistant?		- Select - Excellent Good Fair Poor
How would you rate the quality of care your pet received from the veterinarian?		- Select - Excellent Good Fair Poor
How long did you wait before you were seen by a veterinarian?		- Select - I was seen very quickly I waited a reasonable amount of time I waited too long
Were your concerns and questions addressed to your satisfaction?		- Select - Yes No
If your pet was hospitalized, were you kept informed of your pet's condition while in our care?		- Select - Yes No Not applicable
If your pet was hospitalized, were you updated daily on the cost of your pet's care and treatment?		- Select - Yes No Not applicable
Overall, were the doctors and staff friendly and courteous?		- Select - Yes No
Were the doctors and staff compassionate?		- Select - Yes No
Were you satisfied with the cleanliness of the lobby, exam rooms, and outside areas?		- Select - Yes No
How would you rate the quality of care relative to the amount of the bill?		- Select - Low Reasonable High
How would you rate the overall satisfaction of your visit?		- Select - Excellent Good Fair Dissatisfied
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: