Baker County Health Department Satisfaction Survey
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1.

1. What is your sex?

What is your sex? Male

Female

2. What is your age?

What is your age?

3. Where do you live?

Where do you live? Macclenny

Glen St. Mary

Sanderson

Baxter

Cuyler

Taylor

Olustee

Blackbottom

Jacksonville

Baldwin

Other (please specify)

4. Have you ever been to the Baker County Health Department?

Have you ever been to the Baker County Health Department? Yes

I don't know

5. If yes, how would you rate our services?

	Poor	Fair	Good	Great
Customer Service	*If yes, how would you rate our services? Customer Service Poor	Customer Service Fair	Customer Service Good	Customer Service Great
Timeliness	Timeliness Poor	Timeliness Fair	Timeliness Good	Timeliness Great
Cleanliness	Cleanliness Poor	Cleanliness Fair	Cleanliness Good	Cleanliness Great
Patient Care	Patient Care Poor	Patient Care Fair	Patient Care Good	Patient Care Great
Services offered and/or given	Services offered and/or given Poor	Services offered and/or given Fair	Services offered and/or given Good	Services offered and/or given Great

6. Please provide comments or suggestions on how we might improve our services to you.

Please provide comments or suggestions on how we might improve our services to you.

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