Health Department Customer Satisfaction Survey

Dear Valued Customer of the Frederick County Health Department,

Please help us to better understand and serve our customers' needs by answering the following questions:

Question Title

* 1. Date of service

Date / Time

Date

Time

AM/PM

Question Title

* 2. Name of person who helped you:

Question Title

* 3. What service did you use?

Adult Evaluation & Review Services (AERS)

Audiology

Bill inquiry

Birth certificate

Burn permit

Cancer Program

Care for sick/injured students in public school

Children's Dental Clinic

CORE

Death certificate

Environmental information

Food permit

Hearing and Vision Screening in public and private schools

HIV Testing & Care

Immunization Clinic

Infants & Toddlers Program

Medicaid Transportation

Medical Assistance/Medicaid/Health Insurance

Medication and treatment administration to students at public school

Mental Health

Navigator

Payment/Payment Inquiry

School-based Services (Occupational & Physical Therapy)

Smoking Cessation

Special Delivery

Substance Use Recovery Support

Tuberculosis treatment

Well & Septic Permit

WIC (Women, Infants, and Children)

Other (please specify)

25% of survey complete.