Client Feedback Form

Name: The Animal Hospital of Adel
Address: 1126 Greene St., Adel, IA, 50003, United States
Telephone: 515-993-3410
Price range: $

APPOITNMENT

We’d love to hear your feedback!

Please complete our Client Feedback Form below after your first visit. If you have any questions, please don’t hesitate to contact us!

Name *

First

Last

Email *

General Patient Information

How would you rate our concern for you & your pet’s privacy? *

Outstanding
Good
Adequate
Needs Improvement
Poor
N/A

How often have you visited our practice within the past year? *

First Visit
2-5 Visits
More than 6

Scheduling Your Appointment

How did you schedule the appointment? *

Phone Call
Online
Drop In

If you scheduled an appointment, did you have to wait longer than expected?

How easy was it to make an appointment by telephone?

Very Easy
Easy
Difficult
Very Difficult
N/A

How easy was it to make an appointment online?

Very Easy
Easy
Difficult
Very Difficult
N/A

Was the person who scheduled your appointment courteous and helpful?

Very Courteous
Courteous
Indifferent
Rude
N/A

Day of Your Appointment

How would you rate the courtesy of the staff at the reception desk? *

Very Courteous
Courteous
Indifferent
Rude
N/A

How long did you wait in the reception area beyond your scheduled appointment time? *

0-5 Minutes
5-20 Minutes
20-40 Minutes
More than 40 Minutes

How long did you wait in the exam room before the veterinarian appeared? *

0-5 Minutes
5-20 Minutes
20-40 Minutes
More than 40 Minutes

The Medical Support Staff

Did the support staff member clearly identify themselves & their qualifications? *

How would you rate the competence of the technician/assistant who helped you? *

Outstanding
Good
Adequate
Needs Improvement
N/A

How would you characterize the concern that the technician/assistant showed? *

Outstanding
Good
Adequate
Needs Improvement
N/A

Did the technician/assistant respond to your requests within a reasonable period? *

How would you rate the professionalism and competence of the technician/assistant?

Outstanding
Good
Adequate
Needs Improvement
N/A

The Doctor

Were you able to see the veterinarian of your choice? *

Did you feel that your veterinarian spent an adequate amount of time with you? *

How would describe the demeanor of your veterinarian? *

Attentive/Concerned
Distracted
Rushed/Inconsiderate

How would you rate the competence of your veterinarian? *

Outstanding
Good
Adequate
Needs Improvement
N/A

Did you feel that your veterinarian’s examination was thorough? *

How do you feel about the clarity of the veterinarian’s explanation of your pet’s condition & treatment options? *

Outstanding
Good
Adequate
Needs Improvement
N/A

How well did your veterinarian include you in healthcare decisions? *

Outstanding
Good
Adequate
Needs Improvement
N/A

Were your questions answered to your satisfaction? *

Additional Feedback

Please list any areas in which our service could be improved…

Please share any additional comments…

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Full-service veterinary care in Adel, IA.

At our facility, we offer personalized care. We continually strive to meet and exceed all of your expectations. We provide all basic veterinary services, which include: surgery, medicine, radiology, and dentistry.

APPOINTMENT

Location

1126 Greene St.
Adel, IA 50003

Contact Us

P: 515-993-3410
F: (515) 993-5763
E: healthcareteam@animalhospitaladel.com

Hours

Mon-Fri: 8:00 am – 6:00 pm
Sat: 8:00 am – 12:00 pm
Sun: Closed
For after-hours emergencies, click here

Say hello!

Send our team a message using the form below, and we’ll get back to you as quickly as possible! If you need immediate assistance, please call us directly at 515-993-3410.

Name *

First

Last

Email *

Phone

How can we help you? *

Name

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