Customer Satisfaction Survey Question Title * 1. Overall, how satisfied or dissatisfied are you with the services of the Noble County Health Department? Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied OK Question Title * 2. Which of the following words would you use to describe our services? Select all that apply. Reliable Personalized Useful Convenient Friendly Flexible Slow Ineffective Hard to obtain Unreliable Not for Me Unprofessional OK Question Title * 3. How well do our services meet your needs? Extremely well Very well Somewhat well Not so well Not at all well OK Question Title * 4. How would you rate the quality of the service? Very high quality High quality Neither high nor low quality Low quality Very low quality OK Question Title * 5. When was the last time you received services from the health department? Within 6 months 6 months to 1 year 1 - 2 years Over 2 years OK Question Title * 6. How long have you received services from the health department? This is my first time Less than 1 year 1 - 2 years 2 - 5 years Over 5 years OK Question Title * 7. How likely are you to return for services again? Extremely likely Very likely Somewhat likely Not so likely Not at all likely OK Question Title * 8. How likely is it that you would recommend the health department to a friend or colleague? Extremely likely Very likely Somewhat likely Not so likely Not at all likely OK Question Title * 9. Please briefly describe the interactions with the health department that led you to the answers above. If you would like to be contacted, leave your name and phone number. OK Question Title * 10. Which health department programs/services have you used? (Check all that apply) Environmental Health Vital Statistics (Birth/Death Records) Nursing Services Help Me Grow/Early Head Start WIC Other OK Question Title * 11. Do you have any other comments, questions, or concerns? OK DONE