Wildlife Animal Clinic Survey

This is a survey to assess the interaction of the Public to the Agency used for the Wildlife Animal Clinic. Your participation with this survey will assist in better service for the animal and the agency assisting.

Your First Name:      Your Last Name:     

Agency Contacted:  

Type of Animal:   Wild Bird Squirrel Deer Ground Hog Raccoon Other

Response Rating of the Agency:  

Respect for the Animal:   High Level Low Level

Was Equipment for Transport Provided?:  

How would you rate the knowledge of the Agency to Assist?:  

Your Comments: