Client Feedback Form

Client Feedback
We are committed to providing the highest level of care to you and your pet. Please help us address concerns and continue to improve.
- Which VERC service did you use? Select all that apply.*
  - Emergency/Critical Care
  - Cardiology
  - Diagnostic Imaging
  - Internal Medicine
  - Interventional Radiology
  - Surgery
  - Oncology
- My pet received high quality care at VERC.*
- The reception staff was kind and courteous.
- The registration form and process was clear and easy to complete.
- The wait to see the veterinarian was reasonable.
- The staff clearly communicated with me regarding my pet's prognosis and care.
- The staff was accessible for questions after I went home.
- Was there a staff member who was particularly helpful?
- If you answered yes, what was their name?
- I would return or refer a friend to VERC
- Please help us improve. If you said no, can you describe your reasons?
- The waiting area and exam rooms were clean and comfortable
- Please help us improve. If you disagreed with the statement, can you describe your experience?
- Comments/Suggestions for Improvements
Related Patient Information
- Date of Visit/Referral
- Patient's Name*
- Your Name*
- Family Veterinarian Name or Clinic Name*
- Your Email
Comments
This field is for validation purposes and should be left unchanged.

Client Feedback