CHESAPEAKE HEALTH DEPARTMENT CUSTOMER SATISFACTION SURVEY

Page One
There was an error on your page. Please correct any required fields and submit again. Go to the first error
Thank you for taking time to complete our customer satisfaction survey. Chesapeake Health Department’s goal is to provide you with high quality, professional and prompt service. By providing your feedback, we can continue to improve our processes and services to meet the expectations of our customers. This survey is completely anonymous unless you wish to leave contact information in the block provided at the end of the survey.
Calendar
2. What services did you receive from the health department today? (check as many as apply) *This question is required.
3. How did you hear about the Drive Thru Flu Clinic?
4. Did you receive the service(s) that you came for today?
Please rate the following areas based on your experience:
6. I was treated courteously and with respect by health department staff.
7. The services at the health department are convenient to use.
8. I received my services in a timely manner.
9. My service needs were met during this encounter.
10. I am satisfied with the services that I received from the Chesapeake Health Department and will recommend them to friends and family
OPTIONAL INFORMATION
If you wish to be contacted, please provide your contact information below. A Chesapeake Health Department representative will contact you to discuss your situation or issue.
Survey Software powered by SurveyGizmo
Survey Software