Questionnaire template
Veterinary Clinic Visit Feedback
Pet owners rate their latest veterinary visit: services received, staff, facility, booking, prices and areas to improve.
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Other · Pets. All Other templates
Questions in this template
Your Recent Visit
Thank you for bringing your pet to us. A few minutes of your feedback helps us look after animals and their owners better.
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When did you last visit the clinic?
Choose one from a list:
- In the past week
- Between one week and one month ago
- Between one and three months ago
- More than three months ago
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What did your pet receive at that visit? Select all that apply.
Choose any that apply:
- Routine health check
- Vaccination
- Treatment for illness or injury
- Surgery
- Dental care
- Other
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Which other service did your pet receive?
Condition: Shown when Other was selected
Open answer
Quality of Service
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Thinking about that visit, how satisfied were you with each of the following?
- Professional conduct of the staff
- Cleanliness of the clinic
- How clearly the vet explained things
- Ease of booking an appointment
- Prices
For each row: choose one:
- Very dissatisfied
- Dissatisfied
- Neutral
- Satisfied
- Very satisfied
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Which of these areas, if any, should we improve? Select all that apply.
Choose any that apply:
- Routine health checks
- Vaccinations
- How staff treat clients and pets
- Booking appointments
- Prices
- Nothing needs improving
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What should we change in the areas you selected? (optional)
Condition: Shown when at least one area was selected
Open answer
Your Suggestions
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Is there anything else you would like to tell us about our services?
Open answer
About You
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What is your gender?
Choose one:
- Female
- Male
- Another gender
- Prefer not to say
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What is your age group?
Choose one:
- Under 25
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or older