Healthy Start Satisfaction Survey We are committed to providing you and your family with the best experience possible, so we welcome your comments. Question Title * 1. You were offered an appointment time convenient for you. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 2. The Healthy Start Coordinator provided me helpful information. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 3. I felt comfortable sharing my concerns with the Healthy Start Care Coordinator. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 4. The Care Coordinator was friendly and supportive. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 5. The Care Coordinator explained the Healthy Start program in a way that I could understand. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 6. The Care Coordinator directed me to other agencies in the community to assist me. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 7. While in the Healthy Start Program, I received information about how to take care of myself and my baby. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 8. The Healthy Start Program was useful to me. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 9. My visit time/duration was Longer than expected Duration I expected Shorter than I expected Question Title * 10. Would you recommend Healthy Start and its services to a friend? Yes No Question Title * 11. [To Q10] Why or why not? Question Title * 12. Would you like to share any additional comments and/or suggestions? Question Title * 13. What is your county of residence? Bay County Gulf County Franklin County Other (please specify) Question Title * 14. (OPTIONAL) Please provide the following information: First Name Last Name Phone Number Done