Customer Service Questionnaire « South Health District

What health department, clinic or office did you visit? *

What was the purpose of your visit? *

Was your wait time acceptable? (If no, please explain in comment box.)

Did you receive friendly and well-organized customer service? (If no, please explain in comment box.)

In the past 12 months, how many times have you visited a public health facility?

Please rate your overall experience. (1 being unsatisfied, 10 being completely satisfied)

Comment Box (please include all suggestions, comments or complaints)

Name

Email *

Phone

Please answer the following question: What is 1 + 2= *

South Health District