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Perry County Health Department Customer Satisfaction Survey
1.
Please tell us your age range.
0-29
30-49
50-64
65 and older
2.
Please tell us your gender.
Male
Female
Prefer not to say
3.
Which services did you seek or receive from The Perry County Health Department? (choose all that apply)
Food Service License/Question
Plumbing Program
Septic Program (Septic Permit, Site Evaluation, Lot Split, etc)
Nuisance Complaint
Vaccines or Immunizations
Head Lice Program
TB Test
Blood Pressure/Sugar Check
Tobacco Program
Car Seat Program
Breast Health
Safe Sleep Program (Pack N Play)
Birth or Death Certificate
Disaster Preparedness Education
Other (please specify)
4.
How convenient to access was our facility?
Extremely convenient
Very convenient
Somewhat convenient
Not so convenient
Not at all convenient
Comments:
5.
How would you rate your wait time (either in the office or on a return phone call)?
About the right length
Too long
Comments:
6.
How friendly were the staff you worked with?
Extremely friendly
Very friendly
Somewhat friendly
Not so friendly
Not at all friendly
Comments:
7.
If we could not serve you, how satisfied were you with the referral or resource we provided?
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Not applicable
Comments:
8.
On a scale of 0 to 10,
How likely is it that you would recommend this organization to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
9.
How have you heard about Health Department services in the past?
Radio
Newspaper
Facebook
Flyers/Handouts
Billboards
Family/Friends/Word of Mouth
I don't recall hearing or seeing information in the past.
10.
Which newspaper(s) and radio station(s) do you read/listen to?
Perry County Tribune
Lancaster Eagle Gazette
Zanesville Times Recorder
Newark Advocate
Logan Daily
No Newspapers
T-100 (WCLT)
105.9 The Mix (WWJM)
107.3 (WYBZ)
Power 105 (WXTQ)
No radio stations
Other (please specify)
Current Progress,
0 of 10 answered