Allen County Public Health Customer Satisfaction Survey Allen County Public Health would like your feedback to make sure we are providing excellent service and care. Please take a few minutes to complete this survey to help us improve. OK Question Title * 1. When did you receive our services? Date Date OK Question Title * 2. What was the MAIN service you received from us? Birth and Death Records CMH - Children with Special Healthcare Needs Cribs for Kids Disease Intervention Specialist (DIS) Environmental Health - Inspections/ Licensing Family Planning/ Reproductive Health and Wellness Services/ STD Testing HIV Testing/ Counseling or Education Immunizations/ Clinic Moms & Babies First Project DAWN WIC - Women, Infants, and Children Other (please specify) OK Question Title * 3. Overall, I am pleased with the service I received. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Not Applicable OK Question Title * 4. The staff treated me well. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 5. I got the information or the service(s) that I needed. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 6. I was served in a timely manner (i.e. wait time). Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 7. The service or information was clear and easy to understand. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 8. What changes, such as access through mobile devices or the computer, could make it easier to use our services? OK Question Title * 9. What other suggestions do you have to help improve our services? Or other comments: OK Thank you for taking our survey! OK Question Title * 10. Optional: If you would like to talk to someone at Allen County Public Health, you can call us at 419-228-4457, OR let us know how to contact you.Please fill out your name and email/ phone ONLY if you want someone to contact you. Name Email or Phone OK Question Title * 11. For office use only. Initial of clerk: OK DONE