Please complete this brief and voluntary survey to tell us about your experience with telehealth appointments with your local Community Service Board. The information that you provide will be used to help us make improvements. Your answers and comments are confidential.

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* 2. Select age group:

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* 3. Using technology for video sessions or telephone calls has helped me: (check all that apply)

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* 4. Telehealth has helped me: (check all that apply)

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* 5. After the current state of emergency/COVID-19 pandemic ends, I would prefer:

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* 6. Overall, I am satisfied with my telehealth appointments.

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* 7. Would you recommend others to use telehealth as an appointment option?

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* 8. Please provide any additional comments or suggestions about your experience with telehealth.

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