Question Title

1. Clinic Name

Question Title

2. Please check

Question Title

3. Approximately, how often are you in contact with CHDP Staff?

Question Title

4. Please select  any  of the following CHDP local program activities you have received (check all that apply)

Question Title

5. CHDP staff acknowledge me, take time to understand my needs, and speak in a respectful
tone.

Question Title

6. CHDP staff is knowledgeable about their work and help me solve problems.

Question Title

7. CHDP staff respond to my questions in a timely manner.

Question Title

8. Have you attended at least one of our CHDP monthly noontime in services ( e.g. Vision screening, Lead in service, School Updates)

Question Title

9. Have you visited the new Ventura County CHDP website (www.vcchdp.org)?

Question Title

10. If you have visited the CHDP website, were you able to find the information you needed?

Question Title

11. Please select  the Children's Medical Services Programs you are familiar with.

Question Title

12. How could we serve you better? Please comment.

Question Title

13. If you would like the results of this survey to be shared with you, please provide:

T