Customer Satisfaction Survey

We realize in order to provide our customers with the best possible service; we need to consider your needs and opinions. This survey is anonymous however you may add personal contact information at the end. Please provide honest answers and thank you for taking the time to assist us in improving our customer service.
  Select one or more departments then rate your experience with their services below.
  Medical
Healthy Start
Immunizations
Environmental Health 		Administration
School Health
Tobacco Prevention
Health Education 		Dental
Healthy Families
WIC
 
Statement Strongly
Agree		 Agree Neither Agree
Nor Disagree		 Disagree Strongly
Disagree
I received the information
or service(s) I needed
The information or service(s)
were clear and understandable
The Staff was polite
and friendly
The Staff was knowledgable
and well informed
The Staff was helpful
I was served in a timely
manner
Statement Very
Satisfied		 Satisfied Neither Satisfied
Nor Dissatisfied		 Dissatisfied Very
Dissatisfied
Overall, how would you rate
your satisfaction with the
information or service(s)
you received?
Additional Comments
If you wish to speak to someone concerning your experience please call 850-926-0400
Thank you for participating.