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Student Health Services Satisfaction Survey
Your experience at Student Health Services is important to us!
We greatly appreciate your feedback which will help us to improve our services to students. Your responses to this survey are anonymous and the information you provide will be treated confidentially. You can skip any questions that you do not feel comfortable answering.
Question 1
Date of visit:
(mm/dd/yyyy)
Question 2
Was this your first visit to Student Health Services (SHS)?
Yes
No
Question 3
What is your gender?
Male
Female
Question 4
What is your age?
Question 5
How many minutes did you wait before you were called to an exam room?
Less than 1 minute
1 - 5 minutes
6 - 10 minutes
11 - 15 minutes
16 - 30 minutes
31 - 45 minutes
More than 45 minutes
Question 6
How many minutes did you wait in the exam room before you were seen by a nurse or nurse practitioner?
Less than 1 minute
1 - 5 minutes
6 - 10 minutes
11 - 15 minutes
16 - 30 minutes
31 - 45 minutes
More than 45 minutes
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