Oakwell Animal Hospital
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Oakwell Animal Hospital
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Location
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Conducted on
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Prepared by
Pre-Visit
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Was the CSR professional?
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Were you able to reach our clinic within 3 rings?
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Were you given at least two options for appointment time?
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Were you able to book appointment at time slot desired?
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Were you asked if this is your first visit?
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Did the CSR ask for phone number, address, and email?
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Did the CSR ask where previous veterinary records can be found?
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Did the CSR answer all questions regarding cost?
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Were you asked how you heard about Oakwell?
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Were you given directions to clinic?
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Did the CSR give reminder at end of call of appointment time and use pets name?
At Appointment
Upon Arrival
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(Upon arrival) Please indicate whether the following statements are true:
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He/she gave me an overview of available services?
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He/she followed up and asked if I had questions?
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There is adequate parking near the building.
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I easily located the clinic?
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There were visible signs that directed me to the entrance.
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Signage clear and readable?
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Windows clean?
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Upon entering, was the reception area/information center welcoming?
CSR
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CSR Name:
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Please indicate whether the following statements are true about your interaction with the resource staff member:
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Did the receptionist/CSR person:
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Was there a receptionist/staff person present?
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Did the receptionist/staff person greet you?
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Did CSR have friendly body language making you feel important?
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Did the CSR use pets name?
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Make eye contact with you?
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Ask how he/she could help you?
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Direct you to where you needed to go?
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Was the receptionist/staff person friendly?
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Was the staff member wearing clean uniform with name?
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Did the staff member ask you to complete a New Client Form sheet?
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Were you offered water while you wait?
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Were you satisfied with the waiting time?
Rate the Medical Staff
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Please rate the Assistant / Technician:
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Assistant/Technician Name:
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Did he/she use pets name?
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Was the staff member friendly and welcoming?
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Attentiveness
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Interaction with pet
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Courteousness
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Helpfulness
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Level of knowledge
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Professional appearance
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Professional behavior
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How well he/she explained things in a clear manner?
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How well he/she treated me with respect?
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How well were questions was answered?
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How well he/she made me feel comfortable?
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How well he/she made my pet feel comfortable?
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Did they weigh your pet?
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Did they take pets temperature?
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Did they explain services for your visit? (vaccines, testing, etc.)
Services
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After spending time at Oakwell and thinking about the services offered, please indicate how satisfied or dissatisfied you were with the following service aspects:
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Staff's knowledge about services
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Staff's knowledge about pricing
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How was the waiting time before you someone came into exam room?
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How was the service?
Veterinarian
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Veterinarian Name:
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Did he/she enter exam room in a timely manner?
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Was his/her uniform neat and clean?
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Did he/she introduce themselves?
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Did the they ask about concerns?
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Did they exam pet and verbalize physical exam?
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Did they show you any of the concerns they found? (ears, teeth, etc.)
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Did they offer testing?
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Did they discuss costs of testing?
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Did they discuss timing of receiving test results?
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Did they explain all findings in an understandable manner?
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Did they explain vaccines?
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Did they vaccinate in the exam room?
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If testing was "sent off to lab", Did the DVM call with results in timeframe you were told at visit?
Environment
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Please rate the shop/center on the following:
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Visual appeal
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Welcoming environment
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How well it was organized
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Was exam room clean?
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Did the exam room smell clean?
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Check Out
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Did CSR ask how visit was?
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Was the CSR friendly?
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Did the CSR use your pets name?
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Did CSR review services, tests, and products received during visit?
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Were you given several payment options?
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Did you receive rabies tag and certificate?
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Were you asked if you wanted to book a follow up appointment?
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Did you receive a printed copy or emailed receipt?
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Were you helped out to vehicle (or at least offered)?
Overall Impression
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What was your overall impression of Oakwell?
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What specifically was done well or impressed you? (Please list specific examples.)
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What could be considered opportunities for improvement? (Please list specific examples.)
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Do you have anything else you'd like to add, including any clarifications of previous responses?
Completion
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Full Name and Signature of Respondent
