Healthe Kids Health Room Survey 2019-2020
Introduction
Thank you for partnering with Healthe Kids to directly impact the health status of young lives! We appreciate you taking the time to complete our survey.
Name:
Your answer
Title:
Your answer
Email Address
Your answer
Phone Number:
Your answer
School Information: *
How many times have you participated in Healthe Kids?
If unsure please explain:
Your answer
Please rate your pre-screening experience on the following:
Outstanding
Good
Adequate
Fair
Needs Improvement
Ease of registering students
Timeliness of form drop off and pick up
Helpfulness of Program Coordinator and Manager
Communications regarding screening dates and schedule
Professionalism of Healthe Kids program staff
Overall organization of Healthe Kids Program
Comments/Suggestions
Your answer
Please rate your experience the day of the screenings based on the following:
Outstanding
Good
Adequate
Fair
Needs Improvement
Friendliness of Healthe Kids staff
Professionalism of Healthe Kids staff
Organization of Healthe Kids program
Efficiency of screenings
Usefulness of program
Comments/Suggestions
Your answer
Please rate the feedback you received on the Healthe Kids experience from the following:
Outstanding
Good
Adequate
Fair
Need Further Explanation
Confusing/Not Useful
From School Staff
From Parents
From Students
Comments/Suggestions
Your answer
Would you recommend our program to other schools?
Comments/Suggestions
Your answer
How helpful are the reports you receive after your screenings?
Other (please specify)
Your answer
What additional screening data would be helpful to you?:
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of First Hand Foundation. Report Abuse