Auburn University College of Veterinary Medicine
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Referring Veterinarian Referral Survey

From (RDVM Email): *
Subject
What type of case did you refer? *
      

What service did you refer your client to? *










Referring Veterinarian's First Name *
Referring Veterinarian's Last Name *
What is the first and last name of the client you referred? *
GENERAL SATISFACTION

What is the name of the faculty clinician to which this case was assigned?
Please rate the overall medical service (doctor and student) provided to your client?
            

Please rate the overall service provided by our front office staff:
            

REFERRAL PROCESS

How would you rate the convenience of our referral process?
            

If you used faxing or electronic referral, was this process completed easily?
          

If applicable, how long did you wait to speak with a referral coordinator?
            

Please rate the staff person who facilitated your referral:
          

(please consider their knowledge, courtesy and helpfulness)
CARE

Please rate the timeliness and quality of communication with our faculty after your patient was admitted:
            

Please rate the timeliness and quality of patient status updates during hospitalization:
            

How do you rate the availability of the doctor/service for ongoing consultation relative to your referred patient's care?
            

Rate the demeanor of the doctor and service managing your client's case:
            

How does your referral service/doctor rate in including you in the healthcare decisions regarding your patient?
            

Please rate the overall competence of your referral service/doctor:
            

Please rate the quality and timeliness of discharge instructions and follow-up information that was provided to you:
            

Based on follow-up with your client, how do you think they would rate their experience at Auburn?
            

Please rate the value that the clients you refer to the hospital receive for their investment:
            

Are you willing to refer additional clients to the Auburn University Veterinary Teaching Hospital?
    

If you could list one area where we need improvement, what would it be?

How recent was your last referral? *






Please list your preference for receiving communication from us ( discharge summaries, notifications, ect.) in the future. We will not make any changes unless you are first notified.
    

Would you be willing to complete a short (2-3 minute) online quality survey after each of your patients is discharged? *
      

General Comments:

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Auburn University | College of Veterinary Medicine | Auburn, Alabama 36849 | (334) 844-4546
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