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* 1. Which Program(s) were you seen in today?

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* 2. Other (Please specify):

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* 3. The staff members were courteous to me....

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* 4. The waiting are was comfortable...

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* 5. I found the materials/information feed on the TV's in the waiting are useful...

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* 6. I waited less than 15 minutes to be seen by staff....

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* 7. I had no problems making an appointment....

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* 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)....

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* 9. If you have received a reminder call or text reminder, did you find it
beneficial?

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* 10. I had enough privacy when speaking with staff.....

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* 11. The hours of service meet my needs....

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* 12. What hours of service would better meet your needs?

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* 13. Overall, how satisfied or dissatisfied were you with your visit to the Health
Department?

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* 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?

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* 15. If you have visited our website at www.tchd.us, how would you rate it?

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* 16. Do you have any recommendations to improve our website?

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* 17. Do you use social media?

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* 18. Are you aware of our Facebook page?

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* 19. Please rate the performance of the following staff:
Clerical:

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* 20. Nurse:

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* 21. Clinic Assistant/Lab Tech:

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* 22. Nurse Practitioner:

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* 23. If you gave a poor or very poor rating, please explain the reason for the
rating so we can make improvements.

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* 24. I felt I was included in or allowed to be an active participant in the care I
received.

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* 25. If you have ever received a billing statement from the Health Department,
did you find the statement easy to read and understand?

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* 26. Have you ever paid for Health Department services using a credit card?

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* 27. What would have made your visit better for you?  (Your name and phone
number are welcome, but not necessary)

0 of 27 answered
 

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