Pregnancy Aid Clinic Exit Survey

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* 1. Please enter the name of the PAC staff member(s) you met with today. (It's ok if you don't remember.)

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* 2. At what location did you receive services?

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* 3. How did you hear about PAC?

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* 4. Did you feel comfortable talking to PAC staff about personal issues?

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* 5. Please let us know if you agree or disagree. If it does not apply to you, check N/A

  Strongly agree Agree Somewhat agree Somewhat disagree  Disagree N/A
The PAC website was easy to navigate
The PAC website had relevant content
Online appointment scheduling was easy
Phone appointment scheduling was easy
Staff was warm and welcoming
Staff was helpful and knowledgeable
I felt heard and listened to
I received the information I was looking for

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* 6. What kinds of services would you like to see us add to our clinic?

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* 7. How can we improve our clinic?

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* 8. Did you receive information about our free classes?

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* 9. Do you feel like your appointment was helpful today?

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* 10. Would you recommend PAC to a friend experiencing a potential pregnancy?

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