TCHD 2019 Agency Survey Health Services Question Title * 1. Which Program(s) were you seen in today? Immunizations Children's Special Health Care Services WIC Maternal & Infant Health Program Family Planning/STI's Other OK Question Title * 2. Other (Please specify): OK Question Title * 3. The staff members were courteous to me.... Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 4. The waiting are was comfortable... Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 5. I found the materials/information feed on the TV's in the waiting are useful... Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 6. I waited less than 15 minutes to be seen by staff.... Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 7. I had no problems making an appointment.... Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 8. When calling the Health Department I was able to contact the person or extension I needed in a timely manner (e.g.: phone call was answered promptly, menu was easy to follow).... Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 9. If you have received a reminder call or text reminder, did you find it beneficial? Yes No Did not receive a reminder call or text OK Question Title * 10. I had enough privacy when speaking with staff..... Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 11. The hours of service meet my needs.... Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 12. What hours of service would better meet your needs? Early Morning - before 8 a.m. Evenings Saturdays OK Question Title * 13. Overall, how satisfied or dissatisfied were you with your visit to the Health Department? Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied OK Question Title * 14. If you have been referred in the last year, were you satisfied with the provider (Other Physician, Agency or Services, etc.) that you were referred to? Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 15. If you have visited our website at www.tchd.us, how would you rate it? Poor Fair Good Very Good Excellent N/A OK Question Title * 16. Do you have any recommendations to improve our website? OK Question Title * 17. Do you use social media? Yes No OK Question Title * 18. Are you aware of our Facebook page? Yes No OK Question Title * 19. Please rate the performance of the following staff:Clerical: Very Poor Poor Good Very Good Excellent OK Question Title * 20. Nurse: Very Poor Poor Good Very Good Excellent OK Question Title * 21. Clinic Assistant/Lab Tech: Very Poor Poor good very Good Excellent OK Question Title * 22. Nurse Practitioner: Very Poor Poor Good Very Good Excellent OK Question Title * 23. If you gave a poor or very poor rating, please explain the reason for the rating so we can make improvements. OK Question Title * 24. I felt I was included in or allowed to be an active participant in the care I received. Strongly agree Agree Neutral Disagree Strongly disagree OK Question Title * 25. If you have ever received a billing statement from the Health Department,did you find the statement easy to read and understand? Yes No N/A OK Question Title * 26. Have you ever paid for Health Department services using a credit card? Yes No OK Question Title * 27. What would have made your visit better for you? (Your name and phone number are welcome, but not necessary) OK DONE