* 1. What was the reason for your most recent visit to St. Francois County Health Center? (choose all that apply)

* 2. Please refer to your most recent visit to St. Francois County Health Center

  Poor Fair Neutral Good Excellent
How would you rate your overall experience with us?
How would you rate the length of time you waited?
How would you rate the customer service you received?

* 3. Please refer to your most recent visit to St. Francois County Health Center

  Poor Fair Neutral Good Excellent
How well was the staff able to answer any questions you had?
What is the likelihood that you would come back to us for similar or additional services?
What is the likelihood that you would refer us to friends or family?

* 4. How did you hear about us?

* 5. Please share anything you think we are doing well.

* 6. What, if anything could we be doing better?

* 7. Please share any additional comments or suggestions.

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