The following statements relate to the services you receive from the Juneau County Health Department

All responses will be kept confidential and will not be viewed individually by Juneau County Health Department and/or WIC staff. Please provide your honest feedback as we would like to use this information to serve you in the best way possible.

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* 1. Which of the following services are you receiving or have received at the Juneau County Health Department?

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* 2. Health Department staff were friendly.

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* 3. Health Department staff were helpful.

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* 4. Health Department staff treated me with respect.

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* 5. Health Department staff took the time to listen to my concerns.

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* 6. Health Department staff helped me feel relaxed or at ease during my services.

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* 7. Health Department staff used words I could understand.

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* 8. Printed materials that I received were easy to read and understand.

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* 9. The services I received met my needs. (this includes social, cultural, and/or special needs)

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* 10. I felt my privacy was protected by Health Department staff.

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* 11. Services were provided in a timely manner.

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* 12. Our main office is open Monday-Friday 8:00am-4:30pm. Do these hours meet your needs.

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* 13. If you marked no to question #12, which of the following hours would better meet your needs?

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* 14. I would recommend the Juneau County Health Department to my friends and family.

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* 15. Overall I am satisfied with the services I received from the Health Department.

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* 16. What did we do well during your most recent visit?

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* 17. What, if anything, did you feel was negative about your experience with us that we could improve on?

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* 18. Did the Juneau County Health Department staff offer you information during your most recent visit about other services you might need?

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* 19. I am likely to return to the Juneau County Health Department for services.

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* 20. How do your prefer to receive information?

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* 21. How did you hear about our services?

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* 22. What is your gender?

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* 23. What is your race? (Choose all the apply)

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* 24. What is your current age?

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* 25. How many children under the age of 18 live in your household?

Thank you for your valuable input. If you have any questions regarding this survey, please contact the Juneau County Health Department at 608-847-9373.

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