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.

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* 1. When did you receive our services?

Date

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* 2. What was the MAIN service you received from us?

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* 3. Overall, I am pleased with the service I received.

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* 4. The staff treated me well.

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* 5. I got the information or the service(s) that I needed.

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* 6. I was served in a timely manner (i.e. wait time).

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* 7. The service or information was clear and easy to understand.

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* 8. What changes, such as access through mobile devices or the computer, could make it easier to use our services?

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* 9. What other suggestions do you have to help improve our services? Or other comments:

Thank you for taking our survey!

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* 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.

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* 11. For office use only.  Initial of clerk:

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