Public Input Survey 2014
The purpose of this survey is intended to find out how often county residents utilize the Franklin County
Health Department's services and to help us improve when, how, and what services we offer. You do not need to put your name on this survey.
. Please check the area(s) in which you received service:
Please check the area(s) in which you received service:
Infant and child health
Immunizations (Childhood and Adult)
Pregnancy Care Management
Community Care 4 Children (CC4C)
Women, Infant and Children (WIC)
Communicable Disease Control (STD, Tuberculosis (TB))
Health Education/Health Promotion
. Which of the following best describes your racial or ethnic background?
Which of the following best describes your racial or ethnic background?
. What is your age?
What is your age?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
Other (please specify)
. What are some things that would make you more likely to visit the Franklin County Health Department?
What are some things that would make you more likely to visit the Franklin County Health Department?
Receiving more information about the services the health department offers
Same-day "call-in" appointments
I think the health department should offer:
. Thinking of your visit, how would you rate the following? (Fill in only one box for each item)
Thinking of your visit, how would you rate the following? (Fill in only one box for each item) Privacy provided Poor
Privacy provided Fair
Privacy provided Good
Privacy provided Excellent
Length of wait time
Length of wait time Poor
Length of wait time Fair
Length of wait time Good
Length of wait time Excellent
Quality of care provided
Quality of care provided Poor
Quality of care provided Fair
Quality of care provided Good
Quality of care provided Excellent
Cleanliness of Health Department
Cleanliness of Health Department Poor
Cleanliness of Health Department Fair
Cleanliness of Health Department Good
Cleanliness of Health Department Excellent
Bulletin Board/Educational Displays
Bulletin Board/Educational Displays Poor
Bulletin Board/Educational Displays Fair
Bulletin Board/Educational Displays Good
Bulletin Board/Educational Displays Excellent
Directional Signs in the Building
Directional Signs in the Building Poor
Directional Signs in the Building Fair
Directional Signs in the Building Good
Directional Signs in the Building Excellent
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