Thank you for sharing your experience with us!

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* 1. At which center did you receive services?

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* 2. What is your age?

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* 3. Are you:

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* 4. What city or town do you live in?

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* 5. How long have you been a patient of OCO's The Centers for Reproductive Health?

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* 6. How many days after you call are you scheduled for an appointment?

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* 7. Are The Centers staff prompt and helpful when you arrive to check-in for your appointment?

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* 8. How easy is it to receive services at The Centers

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* 9. How convenient are The Centers Hours/Days?

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* 10. Please rate The Centers' cleanliness:

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* 11. How helpful was The Centers staff?

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* 12. Do you feel like you were treated respectfully?

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* 13. Were all of your questions and concerns answered?

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* 14. How satisfied were you with The Centers Services?

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* 15. How well did the program meet your needs?

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* 16. What services have been most helpful to you (for example: birth control, STD testing, annual exams)?

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* 17. Were there other services you needed that OCO could not help you with?

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* 18. Would you recommend The Centers to a friend?

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* 19. Please share any additional comments or suggestions you may have for us:

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