2023 Customer Service Satisfaction Survey Question Title * 1. Date of Service Question Title * 2. Which service(s) did you receive today? (Check all that apply.) Immunizations Environmental Health (Food handler card, inspections, etc.) Dental Services Tuberculosis (TB) Services WIC Records (Birth/death certificates, immunization records, medical records) STI Services (Sexually Transmitted Infections) Other (Please explain in the Comments area) Question Title * 3. Which business hours/appointment times might work best for you? (Check all that apply.) 7 am - 8 am 8 am - 11:15 am 11:15 am - 1 pm 1 pm - 3:30 pm 3:30 pm - 5 pm Other (Please explain in the Comments area) Question Title * 4. I was served in a timely manner. Agree Neutral Disagree Question Title * 5. The staff were professional and respectful during my entire visit. Agree Neutral Disagree Question Title * 6. I am satisfied with the services I received today. Agree Neutral Disagree Question Title * 7. Comments? Question Title * 8. If you would like to be contacted, please share your contact information below: Name Email Address Phone Number Done