On a scale of 1 to 5, with 1 being poor and 5 being excellent, please rate your visit with us!

1.How would you rate the friendliness of our staff?

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2

3

4

5

2.How would you rate our facility?

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2

3

4

5

3.How would you rate your over all visit?

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2

3

4

5

4.How likely are you to recommend Sullivan County Regional Health Department to others for services?

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5

5.Which department provided your service today?

Communicable Disease

Adult Clinic

Vital Records

Dental

Womens Health/Family Planning

Pediatric Clinic

WIC

CHANT

6.How did you hear about us?

7.Is there anything else you would like us to know?