You matter to our team at Northeast Colorado Health Department. We are committed to providing you with the best family planning experience. Can you let us know how we can make your experience even better?

Question Title

* 1. Which clinic did you receive services at?

Question Title

* 2. When did you receive services?

Date

Question Title

* 3. Do you consider this clinic your regular source for care?

Question Title

* 4. Gender

Question Title

* 6. How easy was it to schedule an appointment with us?

Question Title

* 7. How easy was it to find our office?

Question Title

* 8. How long were you waiting either in the waiting room or exam room?

Question Title

* 9. How was your nurse or nurse practitioner? Select all that apply.

Question Title

* 10. How was our front desk staff? Select all that apply.

Question Title

* 11. Was the office clean?

Question Title

* 12. Were you comfortable while waiting and did you feel you had privacy?

Question Title

* 13. Please rate your overall experience with the services you have received.

Question Title

* 14. Were the fees and charges explained to you?

Question Title

* 15. Would you recommend services to friends or family?

Question Title

* 16. Explain your answer:

Question Title

* 17. Before today's visit, what had your heard about Long Acting Reversible Contraceptives such as the Liletta IUD and Nexplanon?

Question Title

* 18. What did you like best about the clinic?

Question Title

* 19. What did you like the least about the clinic?

Question Title

* 20. Please share any additional comments or suggestions.

0 of 20 answered
 

T