Shelter
Clinic
Website
Event

2. Reason for your visit?

Animal Adoption
Animal Surrender
Education/Information
Lost & Found
Spay/Neuter Clinic
Vaccination Clinic
Dog Training Classes
Event

3. Name of person who assisted you?

Employee Name

4. Were you acknowledged and greeted in a timely manner when you arrived?

Yes
No
Comment

5. Were you updated in a timely manner as to when you would be helped?

Yes
No
Comment

6. Were you given clear concise information by our staff for any questions asked?

Yes
No
Comment

7. Were you treated in a professional manner?

Yes
No
Comment

8. Was staff courteous and efficient?

Yes
No
Comment

9. Did you adopt an animal today?

Yes
No

10. Did you find all the information you were looking for?

Yes
No
Comment

11. Was our website easy to use and find what you need?

Yes
No
Comment

12. Would you use our services again?

Yes
No
Comment

13. Would you recommed us to a friend?

Yes
No
Comment

14. Other suggestions, comments or complaints.

15. Contact Information (optional):

Name
Address (optional)
City
State	(Click here to choose) Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Canal Zone Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Trust Territories Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon
Zip
Email address
Phone Number