Pike County General Health District Customer Satisfaction Survey
We would love to hear your thoughts or feedback on how we can improve your experience!
What was the date of your visit at PCGHD? *
MM
/
DD
/
YYYY
What services did you receive on the date of your visit? *
Required
How was the quality of the services you received today? *
Were you treated with respect and courtesy from the PCGHD staff? *
The staff at PCGHD was professional, knowledgeable, and competent about my situation. *
My situation was handled in a timely and efficient manner. *
Overall, were you pleased with the services you received here at the PCGHD today? *
If “No”, please explain below:
If you would like to be contacted about your experience today, please leave your name along with phone number or email.
How did you hear about the services that are available at PCGHD? *
Required
Would you return to PCGHD for services? *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy