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North Center Animal Hospital
1808 W. Addison
 Chicago, IL 60613
  (773)327-5050
   Fax:(773)327-0182

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Thank you for taking the time to answer our questionaire. We will use the answers that you provide to try and serve you better.

Form - Questionnaire Form

How were you referred to our office?(check all that apply)
Friend
Drove by
Yellow pages
Our website(www.northcenteranimalhospital.com)
Internet search
Other
Our waiting room was....(check all that apply)
Comfortable
Neat and Clean
Uncomfortable
Disorderly
Odor-free
Needs odor control
Our hours are.....(check all that apply)
Convenient
Restrictive
Should be open more
Should be open later
Our receptionist(s)......(check all that apply)
Stood and greeted you
Were warm and Cheerful
Were cold or unfriendly
Gave you their undivided attention
Seemed distracted or indifferent
Were hospitable
When you telephoned.....(check all that apply)
Your call was answered promptly
There was a long wait for someone to answer
You had trouble getting through
You were placed on hold immediately
You were placed on hold too long
Your phone conversation was ....(check all that apply)
Courteous
Hurried
Impolite
Informative
Preoccupied
Our website was.....(check all that apply)
User friendly
Not user Friendly
Informative
Uninformative
A place you would visit frequently
Our technician.....(check all that apply)
Greeted you warmly
Was gentle with your pet
Seemed proficient
Was knowledgeable
Was a poor communicator
The Veterinarian.....(check all that apply)
Introduced him/herself with a warm greeting
Listened well to my pet's present symptoms
Did not seem interested in what I had to say
Seemed to be in a hurry
Described the diagnosis and treatment well
Left me confused about how to treat my pet
The Veterinarian was.....(check all that apply)
Professional in manner and appearance
Acceptable in manner and appearance
Inferior in manner and appearance
Good at comforting me and my pet
Able to make me feel like a friend
Had a good bedside manner
Had a poor bedside manner
Your waiting time at our hospital was.......
Remarkably short
Reasonable
Unreasonable
Did you understand our fees?
Yes
No
Do you feel our fees were reasonable?
Yes
No
Would you recommend us to a friend?
Yes
No
If you checked no to any of the above fields please explain.

What made you choose our hospital?

What suggestions would you have to improve our office, staff or procedures?

Your name (optional)


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