CCHEA Client Satisfaction Survey

You recently received services from the Consumer Center for Health Education and Advocacy (CCHEA). To help us improve our services, please take a few moments to answer the questions below.

Question Title

* 1. Please rate our services at CCHEA.

Very Good

Good

Just Okay

Not Good

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* 2. Did CCHEA staff help you with your problem as quickly as you thought they should?

Yes

No

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* 3. Was CCHEA staff polite and respectful?

Yes

No

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* 4. Would you refer a friend or family member to CCHEA for help?

Yes

No

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* 5. Additional Comments:

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* 6. Contact Information

Name *

Address

City/Town

State/Province

ZIP/Postal Code

Email Address *

Phone Number *