INTRODUCTION

Please take a moment to give your feedback about your clinic visit today. Check the choice that best represents your response.

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* 1. Health Clinic staff is sensitive to my needs/issues.

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* 2. The Health Clinic staff is able to diagnose and make recommendations for my health needs.

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* 3. The health related resources available at the clinic provided me with the information I needed to solve my health and wellness related issue.

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* 4. The practitioner that met with me today provided me with the information I needed to solve my health and wellness related issue.

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* 5. I am comfortable around the Health Clinic staff.

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* 6. Please choose the Year you visited the health clinic?

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* 7. What was the month that you visited the health clinic?

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