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Chambers Area WHMS Mobile Clinic Survey
1.
What day of the week would you most like to see the mobile clinic in town to see patients?
Monday
Tuesday
Wednesday
Other (please specify)
2.
What services do you think would be the most useful to the community?
Wellness Exams
Sick Visits
Sports Physicals
Vaccine Clinics
Other (please specify)
3.
What locations or events would you most like to a see a mobile clinic at?
4.
We want this mobile clinic to help Chambers! Do you have any other suggestions for ways it could be used to benefit the community?
5.
We will draw for a giveaway prize from our survey responses! Please fill out this question if you would like to be eligible!
Name
Phone Number