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* 1. Please select the department your appointment was with today:

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* 2. Please selected the provider you were seen by:

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* 3. I consider this person to be my primary provider?

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* 4. The ease of getting care in a timely manner at the Red Cliff Community Health Center is:

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* 5. The amount of time I spent in the waiting room for my scheduled appointment was:

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* 6. During my appointment, the provider was organized and the use of my time was:

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* 7. The information explained to me by the provider during my appointment was:

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* 8. I would rate my ability to manage the issue for which I was seen based on the information provided as:

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* 9. Overall, I would rate my care at the Red Cliff Community Health Center as:

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* 10. How can we improve?

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