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
Phone
This field is for validation purposes and should be left unchanged.

Client Feedback