Kanawha-Charleston Health Department Survey

Question Title

* 1. What was the primary purpose for your visit or interaction with KCHD?

Clinic (Vaccinations, testing, personal health questions, etc.)

Environmental (Restaurant inspections, food handling, septic/public health hazards, etc.)

Other (please specify)

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* 2. For each of the following statements, select the level of agreement that best describes how you feel regarding the statement.

	Strongly Disagree	Disagree	Somewhat Disagree	Somewhat Agree	Agree	Strongly Agree
I was treated with courtesy and respect during my interaction with KCHD.	I was treated with courtesy and respect during my interaction with KCHD. Strongly Disagree	I was treated with courtesy and respect during my interaction with KCHD. Disagree	I was treated with courtesy and respect during my interaction with KCHD. Somewhat Disagree	I was treated with courtesy and respect during my interaction with KCHD. Somewhat Agree	I was treated with courtesy and respect during my interaction with KCHD. Agree	I was treated with courtesy and respect during my interaction with KCHD. Strongly Agree
The KCHD staff was knowledgeable and answered my questions and/ or addressed my concerns in an understandable and clear manner.	The KCHD staff was knowledgeable and answered my questions and/ or addressed my concerns in an understandable and clear manner. Strongly Disagree	The KCHD staff was knowledgeable and answered my questions and/ or addressed my concerns in an understandable and clear manner. Disagree	The KCHD staff was knowledgeable and answered my questions and/ or addressed my concerns in an understandable and clear manner. Somewhat Disagree	The KCHD staff was knowledgeable and answered my questions and/ or addressed my concerns in an understandable and clear manner. Somewhat Agree	The KCHD staff was knowledgeable and answered my questions and/ or addressed my concerns in an understandable and clear manner. Agree	The KCHD staff was knowledgeable and answered my questions and/ or addressed my concerns in an understandable and clear manner. Strongly Agree
I feel that I was provided service in a timely manner (i.e., wait time, response time).	I feel that I was provided service in a timely manner (i.e., wait time, response time). Strongly Disagree	I feel that I was provided service in a timely manner (i.e., wait time, response time). Disagree	I feel that I was provided service in a timely manner (i.e., wait time, response time). Somewhat Disagree	I feel that I was provided service in a timely manner (i.e., wait time, response time). Somewhat Agree	I feel that I was provided service in a timely manner (i.e., wait time, response time). Agree	I feel that I was provided service in a timely manner (i.e., wait time, response time). Strongly Agree
Overall, I had a positive experience at KCHD.	Overall, I had a positive experience at KCHD. Strongly Disagree	Overall, I had a positive experience at KCHD. Disagree	Overall, I had a positive experience at KCHD. Somewhat Disagree	Overall, I had a positive experience at KCHD. Somewhat Agree	Overall, I had a positive experience at KCHD. Agree	Overall, I had a positive experience at KCHD. Strongly Agree

Please provide any comments or observations regarding your ratings (especially those "Somewhat Agree” or below) in the section above.

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* 3. How can KCHD improve on any of its products or services?

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* 4. (Optional) Please provide your contact information.

Name

Email Address

Phone Number