Your opinion matters! We use it to improve the services and programs we provide.

Your survey is anonymous.  Thank you for your valuable feedback.

* 1. I received services from Auglaize County Health Department on:

Date / Time

* 2. The main service I received on this date was:

* 3. How long have you been a customer/client of the Auglaize County Health Department?

* 4. If you had an appointment, what form of reminder did you receive? (check all that apply)

* 5. My reminder was helpful:

* 6. Tell us about your experience today.

  Strongly Agree Agree Disagree Strongly Disagree N/A
I was treated with courtesy and respect.
The person who helped me today was informative and professional.
I felt the quality of service was excellent.
The educational materials were in my preferred language and easy to understand.
My wait time was acceptable.
The building and my exam room were clean and accessible.

* 7. What could we have done better? (if answered disagree/strongly disagree above please state why)