Caldwell County WIC Office Visit Evaluation
We'd like to know how well we met your expectations at your most recent visit to our office. Please complete this form below to let us know how we can improve or to let us know what we did well. Participation in this survey will in no way affect your eligibility for WIC services.
What was the reason for your last visit to the WIC office?
Please check all that apply.
Are you:
Please check all that apply.
How many in your family receive WIC services?
How long were you in the WIC office for your appointment?
Which option best describes your overall service that you received at your most recent visit to the WIC office?
What is most beneficial to you about receiving WIC services?
Did you experience any difficulty scheduling your most recent WIC appointment?
If yes, please provide additional information in the comments section at the bottom of this form.
What is your biggest obstacle to making or keeping your WIC appointment?
Are you aware that you may be able to do online nutrition education at wichealth.org?
Have you ever been issued vouchers to go to the local Farmer's Market?
Comments
Please let us know if there is any way that we can make your visit to the WIC Office more enjoyable.
Your answer
We would like to contact you to address the concerns that you have and help us improve. If you would like to be contacted, please provide your contact information below, otherwise your feedback will remain anonymous. If you choose to remain anonymous, we will not be able to directly assist you to resolve your concerns.
Please provide your full name and the best number to contact you at. If you do not wish to be contacted, please leave this question blank.
Your answer
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