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CHS Customer Satisfaction Survey
Please take the time to fill out this survey regarding services you may have received from Meeker, McLeod or Sibley County Public Health Departments.
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1.
What was your date of service?
(Required.)
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2.
What county did you receive service in?
(Required.)
Meeker
McLeod
Sibley
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3.
What type of service did you receive?
(Required.)
In home
Other Location
Phone Call
Other (please specify)
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4.
The service I received was helpful. Please rate your service.
(Required.)
strongly disagree
disagree
agree
strongly agree
strongly disagree
disagree
agree
strongly agree
Why or Why not? Please Explain.
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5.
The service I received met my expectations. Please rate the service you received.
(Required.)
strongly disagree
disagree
agree
strongly agree
strongly disagree
disagree
agree
strongly agree
Why or Why not? Please Explain.
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6.
My service was timely.
(Required.)
strongly disagree
disagree
agree
strongly agree
strongly disagree
disagree
agree
strongly agree
Why or Why not? Please Explain.
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7.
I was treated with respect.
(Required.)
strongly disagree
disagree
agree
strongly agree
strongly disagree
disagree
agree
strongly agree
Why or Why not? Please Explain.
8.
Where there any issues concerning the service you received or any kudos to be given regarding the service you received?
Concerns
Kudos
No concerns or kudos
Please Explain:
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9.
I would recommend public health services to others.
(Required.)
strongly disagree
disagree
agree
strongly agree
strongly disagree
disagree
agree
strongly agree
Why or Why not? Please Explain.
10.
Any other questions, concerns, comments?
Thank you for your time! We are striving to improve the services we offer to residents of Meeker, McLeod and Sibley Counties.
