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Flu Vaccination Patient Satisfaction Survey
1. Is this your first year receiving the flu vaccine at Foothill Community Health Center
2. Why did you decide to attend Foothill Community Health Center to receive the Flu vaccine this year?
Efficient/ less waiting times
Saw notice in/outside store
Was informed about it in Clinic
Worried about getting sick
All of the Above
3. During the visit, were you satisfied with the overall interaction and experience with the Provider about the flu vaccine service? (1 poor to 5 Excellent).
4. Please rate FCHC service when you received the flu vaccine: (1=Poor to 5=Excellent).
5. Will you return next flu season to get your flu vaccine at FCH?
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