Your Health and Your Interactions with Staff

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* 1. How would you rate your overall health?

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* 2. How would you rate your health BEFORE coming to the Community Clinic?

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* 3. How would you rate your health AFTER coming to the Community Clinic?

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* 4. The provider (doctor, dentist, nurse practitioner, counselor, etc.) listens to me.

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* 5. The provider (doctor, dentist, nurse practitioner, counselor, etc.) takes enough time with me.

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* 6. The provider (doctor, dentist, nurse practitioner, counselor, etc.) explains what I need to know.

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* 7. The provider (doctor, dentist, nurse practitioner, counselor, etc.) gives me good advice and treatment.

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* 8. The nurses and medical assistants are friendly and helpful to me.

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* 9. The front office staff members are friendly and they answer my questions effectively.

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* 10. The Community Clinic has addressed my medical, dental, or counseling needs.

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* 11. What do you like best about the Community Clinic?

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* 12. How has the Community Clinic improved your life? 

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* 13. What are your suggestions for improvement of the Community Clinic? 

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* 14. What services have you received from the clinic? (check all that apply)

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