Fulton County Health Department Satisfaction Survey

How are we doing?

Please write a short review of our services to let us know if we met your expectations at the Fulton County Health Department. All answers and comments are anonymous.

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1. Date of Service (approximate if unknown)

Date / Time

Date

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2. What service(s) did we provide (Check all that apply)

Birth/Death Certificate

Immunizations

Reproductive Health & Wellness

Prenatal Care

Breast & Cervical Cancer Project (BCCP)

Women, Infants & Children (WIC)

Support for Families ( CMH-The Child with Medical Handicaps Program, assistance in applying for Medicaid)

Community Education & Engagement (Health Education Services) our community & school based programs such as Safe Communities, MyPlate, HC3, and YAC.

Environmental Services (inspections, investigations, certification, collection)

Car Seat Education, Inspection, Installation

Other (please specify)

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3. Would you recommend us to family and friends?

Yes

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4. What could we have done to improve your visit?

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5. Is there a particular staff member that you would like to mention?

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6. Would you like someone from the Fulton County Health Department to contact you? If so, please add your name, email and/or phone number (will not be shared except for contacting you).

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* 1. Date of Service (approximate if unknown)

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* 2. What service(s) did we provide (Check all that apply)

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* 3. Would you recommend us to family and friends?

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* 4. What could we have done to improve your visit?

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* 5. Is there a particular staff member that you would like to mention?

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* 6. Would you like someone from the Fulton County Health Department to contact you? If so, please add your name, email and/or phone number (will not be shared except for contacting you).

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* 7. Any Additional Comments or Suggestions

1. Date of Service (approximate if unknown)

2. What service(s) did we provide (Check all that apply)

3. Would you recommend us to family and friends?

4. What could we have done to improve your visit?

5. Is there a particular staff member that you would like to mention?

6. Would you like someone from the Fulton County Health Department to contact you? If so, please add your name, email and/or phone number (will not be shared except for contacting you).

7. Any Additional Comments or Suggestions