The Connecticut Humane Society: Survey - Fox Clinic Customer Service Survey

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Fox Clinic Customer Service Survey

1.

Question - Not Required - How did you hear about us:

	Radio
	TV
	Print Ad
	Internet
	Word of Mouth
	Other

2.

Question - Not Required - How did you contact us:

	In person
	Telephone
	Email

3.

Question - Not Required - Was your call or email returned:

4.

Question - Not Required - If other, when were you contacted:

5.

Question - Not Required - Were you greeted when you arrived:

6.

Question - Not Required - Were you treated with courtesy:

7.

Question - Not Required - Comments:

8.

Question - Not Required - Were your needs addressed:

9.

Question - Not Required - Comments:

10.

Question - Not Required - Were you offered alternatives:

11.

Question - Not Required - Comments:

12.

Question - Not Required - Were you thanked:

13.

Question - Not Required - How would you rate your experience with our organization:

14.

Question - Not Required - Comments:

15.

Question - Not Required - Have you had follow-up contact with us:

16.

Question - Not Required - Comments:

17.

Question - Not Required - Would you ever use the services of Fox Memorial Clinic again:

18.

Question - Not Required - Comments:

19.

Question - Not Required - Would you recommend our organization to others:

20.

Question - Not Required - Comments:

21.

Question - Not Required - Do you have any other comments:

22.

If you prefer, you may submit this survey anonymously. However, we require an email address for processing purposes.

Name:

First Required	Last Required

*

Email: Required

Street 1:

Street 2:

City/State/ZIP:

City	State	ZIP

Phone Number:

Yes, I would like to receive e-mail from The Connecticut Humane Society

Yes, I would like to receive postal mail from The Connecticut Humane Society

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