Counseling Services Patient Satisfaction Survey.

1. Your opinion is important to us!

 
Student Health Services
135 East 12th Street, 2nd Floor
Tel: 212.229.1671 opt 1 Fax: 212.614.7484

Please fill out the following survey to let us know if we are meeting your needs. Feel free to complete this anonymously. However, if you wish to be contact by the counseling director, please include your name, phone or email at the end of this survey.
1. Age
2. Gender (Check one)
*
3. Academic Level
4. Where do you live?
*
5. Division
*
6. Have you ever used Student Health Services?
7. Are you aware of the following:
YesNo
Various services offered by SHS?
Counseling office hours?
Counseling office location?
8. What, if anything, has prevented or discouraged you from using Counseling Services?
9. When was the last time you used our services? (Check one)
10. How did you hear about Counseling Services?
(Check all that apply)
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