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* 1. The Franklin County Health Department is open from 8AM- 5PM. How do you feel about the hours of operations?

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* 2. How often do you visit or utilize services provided at the Franklin County Health Department (this includes services / clinics such as pediatrics, dental, prenatal, family planning, environmental health, health education, dental)?

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* 3. When answering the question above, if you checked that you have not used the Franklin County Health Department in 3 or more years, or that you have never used the health department, please tell us why by selecting from the answers below (you may check more than one answer)

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* 4. Thinking of your visit, how would you rate the following? (Fill in only one box for each item).

  Excellent Good Fair Poor
Privacy provided
Length of wait time
Quality of care provided
Cleanliness of Health Department
Bulletin Board / Educational displays
Directional Signs in the building

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* 5. Were you treated in a respectful and sensitive manner?

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* 6. Would you recommend the Franklin County Health Dept. to your family and friends?

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* 7. What are some things that would make you more likely to visit the Franklin County Health Department?

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* 8. Would you be willing to help the Franklin County Health Department find ways to spread the word about the services that they offer, or to help improve our services?

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* 9. (Optional Question)
Which of the following best describes your racial or ethnic background?

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* 10. (Optional Question)
What is your age?

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