Customer Satisfaction Survey Greene County Public Health We are committed to providing you with the best service. Please fill out this survey to help us improve our service. Thank you for your time!Haga clic aquí para la versión en español OK Question Title * 1. The most recent service I received was (select one): 3 Very Poor 3 Poor 3 Average 3 Good 3 Excellent OK Question Title * 2. Select the most recent service(s) you received: Baby and Me Tobacco Free Body Art Program Children with Medical Handicaps Communicable Disease (reporting or monitoring) Community Outreach (fair, health fair, festival) Community Roots Control Program (mosquito, rabies or radon) Cribs for Kids® Early Childhood Home Visiting Early Intervention (Help Me Grow) Emergency Preparedness Epidemiology (outbreak or disease cluster) Food Inspection Program Food Safety Training Program FSO/RFE Plan Review HIV Testing & STI Prevention and Education Housing Jail and Detention Center Inspection Nuisance Abatement and Demolition Inspection Plumbing Inspection Private Water and Sewage Systems Inspection Public Information (media, social media, speaker’s bureau) RV Camp Inspection Safe Communities Safe Trade School Inspection Solid and Infectious Waste Inspection Swimming Pool/Spa Inspection Tobacco Cessation & Prevention TB Testing Vital Statistics (birth and death records) Women, Infants & Children (WIC) or Breastfeeding Peer Helpers Other (please specify) OK Question Title * 3. What is your zip code? Alpha 45301 Beavercreek 45430 Beavercreek 45431 Beavercreek 45432 Beavercreek 45434 Beavercreek 45435 Beavercreek 45440 Beavercreek 45481 Bellbrook 45305 Bowersville 45307 Cedarville 45314 Clifton 45316 Fairborn 45324 Fairborn 45424 Jamestown 45335 So. Charleston 45368 Spring Valley 45370 Wilberforce 45384 WPAFB 45433 Xenia 45385 Yellow Springs 45387 Other (please specify) OK Question Title * 4. Gender Identity? Female Male Transgender Female Transgender Male Other (please specify) OK Question Title * 5. I am in the following age group. Under 18 18-24 25-34 35-44 45-54 55-64 65+ OK Question Title * 6. In general my health is ...? Excellent Very Good Good Fair Poor OK Question Title * 7. In regards to the information or services I needed: Strongly Disagree Strongly Agree I was treated with respect: I was treated with respect: Strongly Disagree I was treated with respect: I was treated with respect: I was treated with respect: I was treated with respect: Strongly Agree I received the information or the service(s) I needed: I received the information or the service(s) I needed: Strongly Disagree I received the information or the service(s) I needed: I received the information or the service(s) I needed: I received the information or the service(s) I needed: I received the information or the service(s) I needed: Strongly Agree I was served in a timely manner: I was served in a timely manner: Strongly Disagree I was served in a timely manner: I was served in a timely manner: I was served in a timely manner: I was served in a timely manner: Strongly Agree OK Question Title * 8. Please share any comments or suggestions. OK DONE
