Skip to content
Healthy Start Satisfaction Survey
We are committed to providing you and your family with the best experience possible, so we welcome your comments.
*
1.
You were offered an appointment time convenient for you.
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
*
2.
The Healthy Start Coordinator provided me helpful information.
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
*
3.
I felt comfortable sharing my concerns with the Healthy Start Care Coordinator.
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
*
4.
The Care Coordinator was friendly and supportive.
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
*
5.
The Care Coordinator explained the Healthy Start program in a way that I could understand.
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
*
6.
The Care Coordinator directed me to other agencies in the community to assist me.
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
*
7.
While in the Healthy Start Program, I received information about how to take care of myself and my baby.
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
*
8.
The Healthy Start Program was useful to me.
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
*
9.
My visit time/duration was
(Required.)
Longer than expected
Duration I expected
Shorter than I expected
*
10.
Would you recommend Healthy Start and its services to a friend?
(Required.)
Yes
No
*
11.
[To Q10] Why or why not?
(Required.)
12.
Would you like to share any additional comments and/or suggestions?
*
13.
What is your county of residence?
(Required.)
Bay County
Gulf County
Franklin County
Other (please specify)
14.
(OPTIONAL) Please provide the following information:
First Name
Last Name
Phone Number