HCGHD Customer Feedback Survey

* 1. What type of interaction did you have with the Holmes County General Health District?

At the Health District's Office

At a facility of point of inspection

A community event

Phone/email coorespondance

Website or Facebook

Clinic

Other (please specify)

* 2. What type of service did you utilize?

Immunizations

Help Me Grow

WIC

Environmental Health/Inspection

Emergency Preparedness

Injury Prevention

Vital Statistics (birth certificates/death certificates)

Other (please specify)

* 3. Based on your service experience with the Holmes County Health District, please rate your level of agreement with the following statements:

	Strongly Disagree	Disagree	Agree	Strongly Agree	N/A
The staff was polite and friendly	The staff was polite and friendly Strongly Disagree	The staff was polite and friendly Disagree	The staff was polite and friendly Agree	The staff was polite and friendly Strongly Agree	The staff was polite and friendly N/A
The staff was attentive and listened to me	The staff was attentive and listened to me Strongly Disagree	The staff was attentive and listened to me Disagree	The staff was attentive and listened to me Agree	The staff was attentive and listened to me Strongly Agree	The staff was attentive and listened to me N/A
The staff was knowledgable	The staff was knowledgable Strongly Disagree	The staff was knowledgable Disagree	The staff was knowledgable Agree	The staff was knowledgable Strongly Agree	The staff was knowledgable N/A
The information I received was clear and understandable	The information I received was clear and understandable Strongly Disagree	The information I received was clear and understandable Disagree	The information I received was clear and understandable Agree	The information I received was clear and understandable Strongly Agree	The information I received was clear and understandable N/A
My service was handled efficiently	My service was handled efficiently Strongly Disagree	My service was handled efficiently Disagree	My service was handled efficiently Agree	My service was handled efficiently Strongly Agree	My service was handled efficiently N/A
The location was clean and had a positive appearance	The location was clean and had a positive appearance Strongly Disagree	The location was clean and had a positive appearance Disagree	The location was clean and had a positive appearance Agree	The location was clean and had a positive appearance Strongly Agree	The location was clean and had a positive appearance N/A
The hours are convenient	The hours are convenient Strongly Disagree	The hours are convenient Disagree	The hours are convenient Agree	The hours are convenient Strongly Agree	The hours are convenient N/A
The amount of time I waited was reasonable	The amount of time I waited was reasonable Strongly Disagree	The amount of time I waited was reasonable Disagree	The amount of time I waited was reasonable Agree	The amount of time I waited was reasonable Strongly Agree	The amount of time I waited was reasonable N/A
Any issues I had were resolved	Any issues I had were resolved Strongly Disagree	Any issues I had were resolved Disagree	Any issues I had were resolved Agree	Any issues I had were resolved Strongly Agree	Any issues I had were resolved N/A
I received the proper follow-up and support that I need	I received the proper follow-up and support that I need Strongly Disagree	I received the proper follow-up and support that I need Disagree	I received the proper follow-up and support that I need Agree	I received the proper follow-up and support that I need Strongly Agree	I received the proper follow-up and support that I need N/A
The Holmes County Health District understand the community and its needs	The Holmes County Health District understand the community and its needs Strongly Disagree	The Holmes County Health District understand the community and its needs Disagree	The Holmes County Health District understand the community and its needs Agree	The Holmes County Health District understand the community and its needs Strongly Agree	The Holmes County Health District understand the community and its needs N/A
I trust the Holmes County Health District	I trust the Holmes County Health District Strongly Disagree	I trust the Holmes County Health District Disagree	I trust the Holmes County Health District Agree	I trust the Holmes County Health District Strongly Agree	I trust the Holmes County Health District N/A
I understand the value of the Holmes County Health District and its services	I understand the value of the Holmes County Health District and its services Strongly Disagree	I understand the value of the Holmes County Health District and its services Disagree	I understand the value of the Holmes County Health District and its services Agree	I understand the value of the Holmes County Health District and its services Strongly Agree	I understand the value of the Holmes County Health District and its services N/A
Overall, I was satisfied with my experience	Overall, I was satisfied with my experience Strongly Disagree	Overall, I was satisfied with my experience Disagree	Overall, I was satisfied with my experience Agree	Overall, I was satisfied with my experience Strongly Agree	Overall, I was satisfied with my experience N/A

* 1. What type of interaction did you have with the Holmes County General Health District?

* 2. What type of service did you utilize?

* 3. Based on your service experience with the Holmes County Health District, please rate your level of agreement with the following statements:

* 4. Please provide any other comments or feedback about your experience that may help the Holmes County Health District improve its services