JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
How important are your pet's medical records?
Hi there --
We are a startup company based in San Francisco, developing a medical records manager service for pet owners. Our mission is to help pet owners take better care of their pets in an efficient and more convenient way, while also allowing them to share their records with their veterinarian.
We need your assistance with answering to a few very short questions.
We will use this information internally to test and define our product and will not make any other use of this information.
Please let us know if you think of additional parameters worth our attention.
Thank you for your time!
Sign in to Google
to save your progress.
Learn more
Before we get started - if you would like to get a lifetime of free use, and an early access to our app please enter your email address
We respect your privacy and will not use your email for any other purpose.
Your answer
Where do you live?
Please specify country and city
Your answer
How many pets do you own?
1
2
More than 2
Other:
Clear selection
What kind of pet do you own?
Dog
Cat
Both
Other:
Clear selection
How old is your pet?
If you have more than 1 please refer to the youngest one
Less than 1 year
Between 1 and 5 years
Between 5 and 10 years
More than 10 years
Clear selection
Do you keep your pet's medical records?
Yes, all of them
Part of them
Not at all
Clear selection
How important is it to keep your pet's medical records?
1- Not important-------- 5- Very important
1
2
3
4
5
Clear selection
What kind of documents or details do you keep?
Visit reports
Vaccination documents
Medications/prescriptions
Nothing
Other:
How do you manage to get all of your pet's medical record?
Documents, reports, etc...
I ask for a hard copy of every visit summary
My vet has provided me with a user name and password to an online service
My vet sends it to me by email or mail
I do not get any records after visiting my vet
Other:
Please specify the importance of each feature in your opinion
1- Not important-------- 5- Very important
Storage of your pet's medical record?
Store your documents with one click and easy tags
1
2
3
4
5
Clear selection
Reminders for vet visits, grooming, feeding, play time, etc...?
1
2
3
4
5
Clear selection
Digital vaccination summary?
1
2
3
4
5
Clear selection
Personalized wellness advice for your pet?
1
2
3
4
5
Clear selection
Your pet's medication and prescription information?
1
2
3
4
5
Clear selection
Flight preparations?
Everything you will need for traveling with your pet
1
2
3
4
5
Clear selection
24/7 online advice from a veterinarian?
1
2
3
4
5
Clear selection
Direct and fast connection with your providers - such as grooming, dog walkers, trainers, play dates, veterinarian, food supplier, etc...?
1
2
3
4
5
Clear selection
Can you think about a feature that could make your or your pet's life easier?
It can be anything you think of
Your answer
In case of emergency, do you believe you will have all the medical information you need to provide regarding your pet?
Yes, I have it all filed or scaned
Yes, If my vet will be available to answer my call
No, I will not be able to provide the information
Would you consider sharing your pet's medical records online enabling other pet owners and vets to learn from it and help other pets?
Yes
No
Other:
Clear selection
Would you consider using an online service for managing your pet's medical records?
You will be able to share it with your vet
Yes
No
Other:
Clear selection
If you would not use it, what will be the main reason?
Too much work
I am counting on my vet to save it for me
Privacy issues
Other:
Clear selection
If you would use it, would you be willing to pay for it?
Yes
No
Other:
Clear selection
Please specify the price you would consider paying per month for an online medical records manager
$1-3
$3-5
$5-7
$7-10
Clear selection
Thank you! Please feel free to leave any comments or ideas you may have
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report