Fallon County Health Department Community Feedback Survey
Your responses help us improve public health services. All information is handled per HIPAA compliance.
This survey is anonymous and does not collect contact information.
Age Range
*
Please Select
Under 18
18–24
25–34
35–44
45–54
55–64
65+
By submitting this form, you consent to the HIPAA-compliant handling of your health-related information by FALLON COUNTY HEALTH DEPARTMENT.
How satisfied are you with the health services provided by Fallon County Health Department?
*
Not at all satisfied
1
2
3
4
Very satisfied
5
1 is Not at all satisfied, 5 is Very satisfied
How easy is it to access health services in your community?
*
Very difficult
1
2
3
4
Very easy
5
1 is Very difficult, 5 is Very easy
How would you rate the professionalism of the staff?
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Which services have you used at Fallon County Health Department? (Select all that apply)
Immunizations
Health screenings
Family planning
WIC (Women, Infants, and Children)
Community health education
Other
Please share any additional comments or suggestions for improvement.
Submit Feedback
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