Fresno County Rural Mobile Health Feedback Survey

Question Title

* 1. Were you satisfied with the services you received today?

Yes

No

Comments:

Question Title

* 2. Would you return to this clinic for services in the future?

Yes

No

Comments:

Question Title

* 3. Are there other services you would like to have access to?

Yes

No

Comments:

Question Title

* 4. Day you received services:

Date:

Date