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The Jefferson County Health Department would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses will be used to improve our services. All responses will be kept confidential and anonymous. The Survey will take about 5 minutes to complete. Thank you for your time. Please start the survey now by clicking on the Continue button below.
 
 
What is your gender?
 
 
What is your age?
   
 
 
 
What is your ZIP code?
   
 
 
 
Enter the date you received service at the Jefferson County Health Department (JCHD).
 
 
 
Select which services you received from JCHD (select all that apply):
 
Birth/Death Certificate
 
Dental
 
Environmental Services
 
Immunization
 
Reproductive Health Services
 
TB Clinic
 
Prenatal Care

 
 
 
Describe the ease of getting in to be seen:
 
 
 
Describe the hours JCHD is open:
 
 
 
Describe the convenience of JCHD's two locations:
 
 
 
Describe the promptness of phone call returns:
 
 
 
Describe your time in the waiting room:
 
 
 
Describe your time in the exam room:
 
 
 
Describe your time waiting for tests to be performed:
 
 
 
Describe your time waiting for test results:
 
 
 
To what extent was the staff friendly and helpful?
 
 
 
Describe the ability of the staff to answer your questions:
 
 
 
To what extent was the staff professional and qualified?
 
 
 
Describe your satisfaction with how much you paid:
 
 
 
The explanation of fees was:
 
 
 
The collection of payment/money was:
 
 
 
To what extent was the building neat and clean?
 
 
 
Describe your comfort and safety while waiting:
 
 
 
Describe the level of privacy you felt:
 
 
 
Describe the confidentiality of JCHD (ability to keep your information private):
 
 
 
Describe the likelihood of referring your friends and family to JCHD:
 
 
 
Describe your likelihood of coming in for immunizations on a Saturday:
 
 
 
How often do you have trouble understanding what a doctor or nurse says to you during a visit?
 
 
 
How often do you have trouble understanding health information given to you or displayed by JCHD?
 
 
 
How often is filling out medical forms difficult or confusing for you?
 
Please contact [email protected] if you have any questions regarding this survey.
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