WIC Satisfaction Survey

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* 1. How satisfied are you with your last WIC appointment?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Dissatisfied

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* 2. How did you complete your last WIC appointment?

Phone call

Video

In-person in the WIC clinic

On-line using wichealth.org

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* 3. What is your preferred method of completing your appointment?

In-person in the WIC clinic

Over the phone

From my home using video

Over the internet using wichealth.org

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* 4. How likely is it that you would recommend phone or video appointments with Fresno EOC WIC to a friend or family member?

	1. Not at all likely	2.	3.	4.	5. Extremely likely
Likelihood of recommending phone/video appointments	Likelihood of recommending phone/video appointments 1. Not at all likely	Likelihood of recommending phone/video appointments 2.	Likelihood of recommending phone/video appointments 3.	Likelihood of recommending phone/video appointments 4.	Likelihood of recommending phone/video appointments 5. Extremely likely

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* 5. How would you rate the customer service you experienced from the employee who helped you at your last WIC appointment?

Excellent

Good

Okay

Not great

Very poor

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* 6. To help us with training and recognition, type the name of the employee who helped you.

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* 7. Were your questions answered and your concerns addressed during your la st WIC appointment?

Yes

No

I didn't have questions

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* 8. Were you treated with dignity and respect?

Yes

No

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* 9. Do you have any other suggestions or comments for us today?

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* 10. If you are willing to provide more information about your appointment, please provide your contact information

Name

Email Address

Phone Number