Class: Freshman Sophomore Junior Senior Gender: Male Female

Please check the most accurate answer for each question.

1. How many times have your visited Parsons Student Health Center this academic year?
1 visit
2-5 visits
6-9 visits
10 or more visits

2. Was your more recent visit to Parsons Student Health Center for:
administration of allergy shots
administration of immunizations or a TB skin test
to be seen by a physician
to be seen by a nurse
Women's Health Clinic appointment

3. How satisfied were you with the overall quality of care and services you received?
very satisfied
satisfied
no opinion
dissatisfied
very dissatisfied

4. How satisfied were you with the length of time you had to wait before being seen by a practitioner?
very satisfied
satisfied
no opinion
dissatisfied
very dissatisfied

5. How satisfied were you with how helpful and courteous the front desk staff were to you?
very satisfied
satisfied
no opinion
dissatisfied
very dissatisfied

6. How satisfied were you with how helpful, courteous and understanding the clinical staff were who treated you?
very satisfied
satisfied
no opinion
dissatisfied
very dissatisfied

7. How satisfied were you with the explanation and information you received concerning your problem and the recommended treatment?
very satisfied
satisfied
no opinion
dissatisfied
very dissatisfied

8. How satisfied were you with the cleanliness and appeal of the facility?
very satisfied
satisfied
no opinion
dissatisfied
very dissatisfied

9. Do you feel satisfied that your privacy was protected?
very satisfied
satisfied
no opinion
dissatisfied
very dissatisfied

10. Would you recommend this service to fellow students?
Yes
No

11. If you attended the Women's Health Clinics, do you have any suggestions or comments?

12. Do you have suggestions for how we can serve the needs of Centre College students better?

Additional comments.