Defiance County General Health District's Customer Satisfaction Survey Welcome to DCGHD's Customer Satisfaction Survey! Please press "Done" when you finish to save & submit your answers. Thank you for helping us to improve our services! Question Title * 1. Date of Service Date / Time Date Question Title * 2. What service was provided to you? (ex. Inspection, WIC Services, Carseat class). Question Title * 3. Was the staff helpful? Yes No Question Title * 4. Was the staff friendly? Yes No Question Title * 5. How did you hear about Defiance County Public Health Service(s)? Question Title * 6. How would you like to learn about Defiance County Public Health programs and services? Quarterly Newsletters Social Media Billboard Health fairs Flyers and Pamphlets Other (please specify) Question Title * 7. Please list any additional programs or services that you would like to see offered by Defiance County Public Health? Question Title * 8. Please select the age(s) of the person(s) receiving our service. 0-7 8-15 16-24 25-34 35-44 45-54 55-64 65+ Question Title * 9. Please select your gender Male Female Question Title * 10. Please indicate how much you agree or disagree with the following statements. Strongely Agree Agree Neutral Disagree Strongly Disagree N/A I am happy with my overall experience I am happy with my overall experience Strongely Agree I am happy with my overall experience Agree I am happy with my overall experience Neutral I am happy with my overall experience Disagree I am happy with my overall experience Strongly Disagree I am happy with my overall experience N/A I am satisfied with the services I received I am satisfied with the services I received Strongely Agree I am satisfied with the services I received Agree I am satisfied with the services I received Neutral I am satisfied with the services I received Disagree I am satisfied with the services I received Strongly Disagree I am satisfied with the services I received N/A I thought the verbal instructions/advice were easy to understand I thought the verbal instructions/advice were easy to understand Strongely Agree I thought the verbal instructions/advice were easy to understand Agree I thought the verbal instructions/advice were easy to understand Neutral I thought the verbal instructions/advice were easy to understand Disagree I thought the verbal instructions/advice were easy to understand Strongly Disagree I thought the verbal instructions/advice were easy to understand N/A My questions were answered My questions were answered Strongely Agree My questions were answered Agree My questions were answered Neutral My questions were answered Disagree My questions were answered Strongly Disagree My questions were answered N/A I am likely to recommend Defiance County Public Health to family or friends I am likely to recommend Defiance County Public Health to family or friends Strongely Agree I am likely to recommend Defiance County Public Health to family or friends Agree I am likely to recommend Defiance County Public Health to family or friends Neutral I am likely to recommend Defiance County Public Health to family or friends Disagree I am likely to recommend Defiance County Public Health to family or friends Strongly Disagree I am likely to recommend Defiance County Public Health to family or friends N/A Your opinion matters! Thank you for taking our survey! Done
