YCMC Client Satisfaction - English Question Title * 1. Why did you choose to come to the Medical Clinic? Convenient Affordable Recommended Quality of Care Other (please specify) Question Title * 2. How did you hear about us? I was already a patient Family and friends Hands of Hope Medical Clinic A community resource (day care, church, food pantry, etc.) Another government agency (Social Services, Schools, Courts, etc.) Employer My primary care provider An urgent care Other (please specify) Question Title * 3. Why are you here today? Child Health Family Planning Maternal Health Immunizations Only Adult Health Other Services Question Title * 4. Please rate our customer service and facility? Excellent Good Poor Check In/Check Out Check In/Check Out Excellent Check In/Check Out Good Check In/Check Out Poor Nurses Nurses Excellent Nurses Good Nurses Poor Doctors Doctors Excellent Doctors Good Doctors Poor Cleanliness Cleanliness Excellent Cleanliness Good Cleanliness Poor Appearance Appearance Excellent Appearance Good Appearance Poor Question Title * 5. How satisfied are you with the ability to access care (appointment availability)? Not satisfied Neutral Satisfied Very Satisfied N/A Question Title * 6. How well were you able to understand information provided by the healthcare provider? Not at all Somewhat Good Very Good N/A Question Title * 7. Are the clinic hours good for you? Yes No Question Title * 8. Which of the following do you like? Written Instruction Verbal Instruction Classes Question Title * 9. Overall, how was our service? Excellent Good Poor Question Title * 10. If it is poor can you tell us why? Question Title * 11. How long were you at the clinic today? less than 30 minutes between 30 minutes and 1 hour between 1 hour and 1 1/2 hours between 1 1/2 hours and 2 hours more than 2 hours Question Title * 12. Other comments: Done