You must have JavaScript enabled to use this form. Gender: Male Female Other Status: Employee Student Dependent Spouse Retiree Please rate your satisfaction with all items relevant tor your most recent visit. 1.) The ease of scheduling an appointment met my needs. Strongly Agree Agree Neutral Disagree Strongly Disagree 2.) I spent an appropriate amount of time in the Health Center to complete my appointment. Strongly Agree Agree Neutral Disagree Strongly Disagree 3.) The check-in and check-out processes were efficient. Strongly Agree Agree Neutral Disagree Strongly Disagree 4.) The registration staff were friendly, courteous and helpful. Strongly Agree Agree Neutral Disagree Strongly Disagree 5.) The nursing staff assisting my provider were friendly, courteous and helpful. Strongly Agree Agree Neutral Disagree Strongly Disagree 6.) I spent an adequate amount of time with my provider. Strongly Agree Agree Neutral Disagree Strongly Disagree 7.) My provider thoroughly explained my condition and recommended treatment in a way I could easily comprehend. Strongly Agree Agree Neutral Disagree Strongly Disagree 8.) I received explanations about payment and billing options. Strongly Agree Agree Neutral Disagree Strongly Disagree 9.) I felt my confidentiality and privacy were carefully protected. Strongly Agree Agree Neutral Disagree Strongly Disagree 10.) The Health Center clinic was clean and comfortable. Strongly Agree Agree Neutral Disagree Strongly Disagree 11.) Services provided by the laboratory were: Excellent Good Fair Poor Not Applicable 12.) Services provided by the pharmacy were: Excellent Good Fair Poor Not Applicable 13.) My overall experience was: Excellent Good Fair Poor Not Applicable 14.) Would you recommend the Health Center to another student? Definitely Probably I Don't Know Probably Not Definitely Not 15.) Would you use the Health Center again? Definitely Probably I Don't Know Probably Not Definitely Not Any additional comments: Leave this field blank