Customer Satisfaction Survey
One goal of the Southeast Health District is to provide excellent customer service. Please tell us what you think about your experience. Your feedback will help us improve the services we provide to better serve you.
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Section 1 | Quality of Service

 
Where did you receive your most recent service?


 
For whom or what did you receive the service?


 
Please check the box that best describes how you feel about your wait time.

 
Please check the box that best describes how you feel about staff members being both professional and nice.

 
Please check the box that best describes how you feel about your understanding of the provided information or instructions.

 
Please check the box that best describes how you feel about your level of happiness with the care or service given.

 
What service  did you come for or receive?

 
How can we serve you better?

 
I would refer a friend or family member.

     
 
Finally, do you have any comments or concerns you would like to raise?

Remember that answers will be treated with the strictest confidence.
 
Section 2 | About You

To better help us understand the diverse populations we serve, please answer the following optional questions:
 
What is your age group?


 
What is your gender?




 
What is your ethnicity?



Thank you for your feedback!

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