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* 1. Front Desk staff were courteous and respectful

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* 2. Nurses/Medical Assistants were courteous and respectful

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* 3. Provider was courteous and respectful

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* 4. How long did you wait in the waiting room before being called to the clinic?

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* 5. How long did you wait in the exam room before you were seen by a nurse or provider?

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* 6. I had a chance to ask questions

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* 7. My questions were answered in a way that I understood.

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* 8. I understood the treatment plan given to me.

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* 9. I felt safe while in the facility.

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* 10. I could discuss my concerns without being overheard

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* 11. I feel my privacy is protected in this clinic

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* 12. The waiting room was clean & comfortable

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* 13. The exam room was clean & comfortable

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* 14. Do you know how to contact a nurse after hours?

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* 15. Are you satisfied with your visit today?

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* 16. The health department's hours are convenient.

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* 17. Would you recommend us to a friend or family member?

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* 18. How did you hear about our services?

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* 19. What can we do to make your experience better?

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* 20. Program

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