Georgia WIC 2014 Advocate Public Comment Survey Please take a few minutes to complete this survey on the quality of services we provide. We welcome your feedback and appreciate your honesty. Thank you for your cooperation. This survey is optional, and your responses are anonymous and confidential. A summary of the anonymous results may be made available to the public. Question Title * 1. Please select the description that best fits you. Pediatrician OB/GYN Family Physician Nurse Nutritionist/Dietitian Health Department staff Child care center staff School/Head Start staff Other (please specify): Question Title * 2. For each item listed below, please indicate your level of agreement by selecting the response that most closely describes your recent experiences with the Georgia WIC program. (Select one option for each item below) Strongly Agree Agree Neutral Disagree Strongly Disagree Does Not Apply My questions and correspondence are promptly answered by Georgia WIC. My questions and correspondence are promptly answered by Georgia WIC. Strongly Agree My questions and correspondence are promptly answered by Georgia WIC. Agree My questions and correspondence are promptly answered by Georgia WIC. Neutral My questions and correspondence are promptly answered by Georgia WIC. Disagree My questions and correspondence are promptly answered by Georgia WIC. Strongly Disagree My questions and correspondence are promptly answered by Georgia WIC. Does Not Apply I believe my patients/clients benefit from WIC. I believe my patients/clients benefit from WIC. Strongly Agree I believe my patients/clients benefit from WIC. Agree I believe my patients/clients benefit from WIC. Neutral I believe my patients/clients benefit from WIC. Disagree I believe my patients/clients benefit from WIC. Strongly Disagree I believe my patients/clients benefit from WIC. Does Not Apply The benefits of WIC are not worth the added work it takes for me to complete medical documentation forms. The benefits of WIC are not worth the added work it takes for me to complete medical documentation forms. Strongly Agree The benefits of WIC are not worth the added work it takes for me to complete medical documentation forms. Agree The benefits of WIC are not worth the added work it takes for me to complete medical documentation forms. Neutral The benefits of WIC are not worth the added work it takes for me to complete medical documentation forms. Disagree The benefits of WIC are not worth the added work it takes for me to complete medical documentation forms. Strongly Disagree The benefits of WIC are not worth the added work it takes for me to complete medical documentation forms. Does Not Apply Question Title * 3. Do you know if your patients/clients participate in WIC? Yes No Next