Davidson County Health Department Customer Satisfaction Survey

We value you as a customer deserving the best service we can offer. Please tell us how we are doing by answering the following questions about the services you received today. Thank you.

Question Title

* 1. Date of your Visit?

Date

Question Title

* 2. Did you have an appointment?

Yes

Question Title

* 3. What service did you receive today?

BCCCP/Adult Health Clinic

Care Coordination 4 Children (CC4C)

Child Health Clinic

STD Clinic

TB Test or Form

Family Planning Clinic (Birth Control)

Immunizations

Lab Work/Pregnancy Test

Pregnancy/OB Care Management

Prenatal Clinic

Restaurant/Hotel/Pool/Tattoo Artist Inspection or Permit

Septic Records Request

WIC

School Nursing

Public Health Preparedness

Health Education / Car Seats

Birth and or Death Certificates

COVID19 Vaccine

Other (please specify)

Question Title

* 4. How helpful and courteous was our staff?

1-Poor

2-Fair

3-Good

4-Very Good

5-Excellent

1-Poor

2-Fair

3-Good

4-Very Good

5-Excellent

Question Title

* 5. Did staff have the skills/knowledge to meet your needs?

1-Poor

2-Fair

3-Good

4-Very Good

5-Excellent

1-Poor

2-Fair

3-Good

4-Very Good

5-Excellent

Question Title

* 6. How long were you here for your visit?

<15 min

15-45 min

45 min -1 hour

>1 hour < 2 hours

> 2 hours

N/A

<15 min

15-45 min

45 min -1 hour

>1 hour < 2 hours

> 2 hours

N/A

Question Title

* 7. How acceptable was the length of your visit to you?

1-Poor

2-Fair

3-Good

4-Very Good

5-Excellent

N/A

1-Poor

2-Fair

3-Good

4-Very Good

5-Excellent

N/A

Question Title

* 8. How well do the hours we provide services meet your needs?

1-Poor

2-Fair

3-Good

4-Very Good

5-Excellent

1-Poor

2-Fair

3-Good

4-Very Good

5-Excellent

Question Title

* 9. Did you have any concerns about the privacy of your medical information?

Yes

N/A

If yes, please explain.

Question Title

* 10. Would you refer family or friends to Davidson County Health Department?

Yes

Please explain if answered "No"

Question Title

* 11. Comments (Please share any ideas or suggestions for improving our services.)

Question Title

* 12. Would you like someone to call you about the services you received today?

Yes

If yes, what phone number may we contact you at?

Thanks for your feedback! If you would like to discuss anything about your visit in further detail, please contact our Quality Improvement Coordinator at 336-242-2808 or by email at Carrie.Brown@DavidsonCountyNC.gov