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* 1. Overall, how satisfied or dissatisfied are you with the services of the Noble County Health Department?

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* 2. Which of the following words would you use to describe our services? Select all that apply.

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* 3. How well do our services meet your needs?

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* 4. How would you rate the quality of the service?

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* 5. When was the last time you received services from the health department?

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* 6. How long have you received services from the health department?

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* 7. How likely are you to return for services again?

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* 8. How likely is it that you would recommend the health department to a friend or colleague?

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* 9. Please briefly describe the interactions with the health department that led you to the answers above. If you would like to be contacted, leave your name and phone number.

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* 10. Which health department programs/services have you used? (Check all that apply)

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* 11. Do you have any other comments, questions, or concerns?

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