Purdue University

Veterinary Teaching Hospital Referring Veterinarian Survey

Referring Veterinarian Information

Referring Vet Name:

Referring Vet Email:

Address:

Phone:

Fax:

Client Information

Client Name:

Patient Name:

Case Number:

Thank you for referring this case to the Veterinary Teaching Hospital. We are committed to providing the best of care to your patients and service to you, our referring veterinarians.

Your assessment of our management of this referral will help us evaluate and improve our service to you.  Please take a moment to provide us with this valuable information.

1.  Was your call to the Reception Desk handled in a professional and timely manner?

2. Did you receive adequate feedback on the status of your patient?

3. Was the case managed to your satisfaction?

4. Were the discharge instructions clear?

5. Did you have any communication problems regarding this case?

6.Do you have any suggestions for improving the service provided by the teaching hospital?

7. Are your non-emergency consult calls being returned by our clinicians in a timely manner?