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* 1. What program or service did you access today  (choose all that apply)

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* 2. I was satisfied with the quality of the service, information or product I received today

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* 3. I was satisfied with the amount of time it took to receive the service, information or product I received today

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* 4. I was satisfied with the employees providing the service, information or product I received today

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* 5. How would you rate your overall satisfaction with today's visit

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* 6. How can we improve our service?

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