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* 1. What service was provided today?

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* 2. The service was provided by which department?

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* 3. Please rate your overall experience on your visit to Sangamon County Department of Public Health (SCDPH) today:

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* 4. Staff members were knowledgeable on the service provided.

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* 5. Staff members were helpful during your visit.

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* 6. SCDPH’s environment was clean and well-maintained.

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* 7. How many visits have you made to SCDPH in the past 12 months?

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* 8. SCDPH’s services have improved the local community.

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* 9. Which of the following does SCDPH do for the community? (Check all that apply)

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* 10. What is/are the biggest health problem(s) our community faces today? (Check all that apply)

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* 11. Please indicate which of the following categories best describes your age:

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* 12. What is the highest level of education you have completed?

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* 13. How many individuals live in your household?

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* 14. Please indicate which of the following best describes your ethnic background?

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* 15. What is your total household income?

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* 16. Please indicate which of the following best describes your gender:

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* 17. What can SCDPH do to improve the quality of our services?

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* 18. General Comments

0 of 18 answered
 

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