How well did we serve you?

Date of your visit?      Was this your first visit to our office?  Yes  No

Which location did you visit?

Our Appearance Exceeded Met Below N/A
Staff Appearance
Reception Area
Our overall appearance?
Our Staff Exceeded Met Below N/A
Courteous on the telephone
Friendly upon arrival
Promptly recognize your arrival
Respectful during your service
Our overall performance?
Our Office Exceeded Met Below N/A
Prompt answering telephone
Delivered prompt service
Service/Care you received
Provided thorough explanations
Timeliness of inspections
Our overall efficiency?
Our Service Exceeded Met Below N/A
Clinic front desk / reception
Field Staff
WIC reception
Vital Statistics
Health Technician
Physician / ARNP
Our overall service?

Did anyone provide outstanding service?  If so, whom?

Would you recommend our office to others?  Yes  No

Additional Comments:

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For information after business hours please call 941-624-7200.

Department of Health Mission: To protect, promote & improve the health of all people in Florida through integrated state, county, & community efforts.

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