Please rate the following regarding your service from Champaign Health District:

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* 1. Courtesy of staff

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* 2. Provided clear information

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* 3. Convenience of hours

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* 4. Wait time

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* 5. Overall service

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* 6. Please let us know if you have any suggestions/ comments.

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* 7. What day did you visit the health district?

Date / Time

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* 8. If your interaction was with a specific employee, please enter their name here.

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* 9. What division did you visit?

T