Southeast Alabama Veterinary Hospital

540 Westgate Parkway
Dothan, AL 36303

(334)671-1990

www.southeastalabamavet.com

Client Satisfaction Survey Form

Date of your visit

How did you hear about our practice?

Friend/Neighbor
Internet
Yellow Pages
Drove By


Based On A Scale From 1 to 5, Where 5=Excellent And 1=Poor
How would you rate us?

5
4
3
2
1


Professionalism of our staff

5
4
3
2
1


Cleanliness of our facility

5
4
3
2
1


Quality of services received

5
4
3
2
1


Did you have to wait past your Scheduled Appointment Time?

Yes
No


If you Answered "Yes", Please tell us how long you had to wait for your appointment

Did you feel our fees were reasonable

Yes
No


Please feel free to leave us any additional comments

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First Name
Last Name

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