Tell Us How We're Doing.....

1. Approximately, how many times have you EVER visited Student Health & Counseling Services?
   0
   1
   2-5
   6-9
   10-19
   20 or more
    
2. If you made an appointment for your most recent visit, how satisfied were you with the ease of getting the appointment?
   Not at all satisfied
   Somewhat satisfied
   Satisfied
   Very satisfied
   Extremely satisfied
   
   
3.  How would you rate the care and service provided by the following during your most recent visit?
                                                                             Poor         Fair           Very          Excellent           Not
                                                                                                               Good                             Applicable      
   A. Receptionist                                                                       
   B. Medical Assistant/Nursing Staff                                           
   C. Physician/ Nurse Practitioner                                              
   D. Pharmacy                                                                          
   E. Health Educator                                                                    
   F. Counselor/ Psychiatrist                                                                 
   
   
4. How satisfied were you with the overall wait time for services after your arrival for your most recent visit?
   Not at all satisfied
   Somewhat satisfied
   Satisfied
   Very satisfied
   Extremely satisfied
   
   
5. Regarding your contact, during your most recent visit, with the medical provider (physician,  nurse practitioner, or psychiatrist), please rate the following: 
    
                                                                 Poor         Fair           Very          Excellent           Not
                                                                                                                        Good                             Applicable
   A. Their explanation of your condition                                               
   B. Their concern of your condition                                                   
   C. Your understanding of the medical                                              
        advice                  
   
   
6. Overall, how satisfied were you with your most recent visit to Student Health & Counseling Services?
   Not at all satisfied
   Somewhat satisfied
   Satisfied
   Very satisfied
   Extremely satisfied
   
   
7. How important is it for you to have SHCS available for you on campus?
   Extremely unimportant
   Somewhat important
   Important
   Very important
   Extremely important
   
   
8. What can SHCS do to improve the services you receive?

   
   
   

9. How old are you?
   
   
10. What is your gender?
    Male
    Female
    
    
11. How do you describe your ethnicity?
    African American
    Asian, having origins in Japan, China, Korea, Vietnam, Indian
    Hispanic,
    Mexican American
    Pacific Islander, origins in Pac-Islands, Hawaii, Samoa, Guam
    Native American
    Filipino
    Other Non-White, having origins in areas not covered elsewhere
    White, origins in Europe, North Africa, Indian Subcontinent, or the Middle East
    
    
12. What is your academic year?
    Freshman
    Sophomore
    Junior
    Senior
    Graduate/Credential
    Other
     
13. If you have concerns that needs to be addressed personally, please provide us with your
    email or phone number so that our Medical Director may contact you.