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GRDHD Satisfaction Survey

About Your Visit

Please take a moment to answer a few questions about your experience with our practice.  All feedback is completely anonymous and is used for the purposes of improving our services. 
1. Please select your patient status:
2. What is the main purpose of your most recent visit to Green River District Health Department? (Please select one) *This question is required.
3. What type of appointment?
3. Which home visiting program? (Please select one)
3. What type of Health Promotion service did you receive?
3. Please select your level of satisfaction with the following health education and promotion:
Space Cell Very DissatisfiedDissatisfiedNeutralSatisfiedVery Satisfied
The information received was clear.
The information received was useful .
My goals and objectives were met.
I will be able to utilize what I learned.
Staff was well informed.
3. How do you hear about Green River District Health Department programs and services?   *This question is required.
  • * This question is required.
4. What type of records did you receive?
4. What department provided you services?
4. For the service you are rating today, which county of Green River District Health Department assisted you?
4. Please select your level of satisfaction on the following:
Space Cell Very DissatisfiedDissatisfiedNeutralSatisfiedVery SatisfiedN/A
Appointment availability
Amount of time you waited to see your provider
Hours of operation
Office cleanliness
Office location
Staff was informed (knowledgeable)
Staff was friendly and polite
Staff was thorough and attentive
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