Patient Satisfaction Survey Based on your last visit to the Cattaraugus County Health Department Clinic. Please tell us how we did in providing quality health services to you. You must have JavaScript enabled to use this form. Which Clinic did you visit? Olean Salamanca Machias How did you learn about the Health Department's Family Planning Clinic? How did you learn about the Health Department's Family Planning Clinic? - Select - County WebsiteHealth EducatorSchool nurseFamily/FriendNewspaper AdInternetFacebookX/TwitterInstagramBillboardOther… Enter other… Was it easy to make an appointment? Yes No Was the front desk staff courteous and respectful? Yes No Was the clinic location convenient? Yes No The provider who treated me clearly explained what I needed to know Yes No On the day of your appointment, how long did you wait to see the provider? How long did you WAIT? - Select -5 - 10 minutes11 - 20 minutes20 - 30 minutesMore than 30 minutes On the day of your appointment, how long was your visit with the provider? How long was your VISIT? - Select -5 - 10 minutes11 - 20 minutes20 - 30 minutesMore than 30 minutes Are you likely to refer a friend to the clinic? Yes No What changes can we make to improve your clinic experience Leave this field blank
