Customer Service Satisfaction Survey 2022 1. Question Title * 1. Date of Service Date / Time Date OK Question Title * 2. What service(s) would you like to leave feedback for today? (check all that apply): Birth/Death Certificate Community Development Programming and Relationship Building Community Health Assessment / Community Health Improvement Plan Data Collection and Dissemination Dental Services Emergency Response Environmental Health (i.e., Food Handler’s Card, Inspections, Vector Complaints, etc.) Harvesters Immunizations (including COVID-19) Immunization Records Request Medical Records Request Mental Health Services Reportable Condition and Outbreak Investigation STD / STI Services Tuberculosis (TB) Services WIC Unknown OK NEXT