Customer Satisfaction Survey * 1. Which Health Center site are you filling this survey out for? * 2. How easy was it to make your appointment? Very easy Somewhat easy Neither easy nor difficult Somewhat difficult Very difficult * 3. Were the Total Health Care forms easy to understand? Yes No * 4. Was the receptionist/front desk pleasant and helpful? Extremely pleasant and helpful Helpful and pleasant Somewhat helpful and pleasant Not helpful and/or pleasant Extremely unhelpful and/or unpleasant * 5. Was the parking convenient? Very convenient Convenient Neutral Difficult Very difficult * 6. Did you find the treatment area welcoming? Very welcoming Welcoming Neither welcoming nor unwelcoming Unwelcoming Very unwelcoming * 7. Did the providers treat you with respect and empathy during your visit? Extremely respectful Respectful Somewhat respectful Not so respectful Not at all respectful * 8. Did we manage your account appropriately? Extremely well handled Well handled Neither Not well handled Account handled horribly * 9. Do you have any other comments, questions, or concerns? Done