Public Health Department (PHD)

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PATIENT SATISFACTION SURVEY
Please take a moment to give us your suggestions and opinions on the services you received at our Health Care Center. ~~~ THANK YOU

Please rate our services by choosing the appropriate answer or by filling in the blanks.

VerySatisfiedVery Satisfied; SatisfiedSatisfied; UnsatisfiedUnsatisfied

 

Which Health Care Center did you visit? 

  

Date of appointment:

   

Who was your appointment with today?

   

Your name (optional):

   

MAKING YOUR APPOINTMENT
If you made your own appointment (by phone or in person) was our staff courteous and able to accommodate you?

ONCE YOU ARRIVED AT OUR HEALTH CARE CENTER
When you arrived at our center, were you greeted when you came to the registration counter?
Were you informed if there was going to be any delays with your appointment time?   
If yes, how long was your wait?   
Do you feel your provider listened and understood your concern(s)?
How well did your provider meet your primary medical needs?
How complete was your provider in explaining your condition and treatment options?
How courteous and respectful was the nursing staff?
Would you recommend our Health Care Center/your provider to family and friends?
Was there any member of our staff that was particularly helpful to you? (name)  
How would you rate your overall experience at our Health Care Center today?

Comments:

County Employees Are Committed to
“ACE” Values: ACCOUNTABILITY ~ CUSTOMER FOCUSED ~ EFFICIENT 

       

Health Care Centers (HCC) Main Office Lines

Carpinteria HCC (805) 560-1050   -   Franklin HCC (805) 568-2099   -   Lompoc HCC (805) 737-6400

Santa Barbara HCC (805) 681-5488   -   Santa Maria HCC (805) 346-7230   -   SM Women's Health HCC (805) 739-8710