Untitled Document

KSU Student Health Services

(770) 423-6644 phone (770) 499-3655 fax
studenthealthsvc@kennesaw.edu

The care of our patients is our chief concern, and we are continually striving to improve our services. You can help us by answering the following confidential questionnaire. Please give us any suggestions, complaints, grievances, or ideas about our services.

1) Which Student Health Services location did you visit today?
House 52 House 53 University Village

2) What is your overall impression of the Clinic location you visited today? (i.e. office environment, waiting time, privacy & confidentiality, etc)
Poor Fair Good Very Good Excellent N/A

3) What is your overall impression of the care and attention you received today by the Health Care Provider?
Poor Fair Good Very Good Excellent N/A

4) What is your overall impression of the care you received
today by our office staff?
Poor Fair Good Very Good Excellent N/A

5) What is your OVERALL IMPRESSION of the quality of care and services you received today?
Poor Fair Good Very Good Excellent N/A

Comment(s):

Ideas/Suggestions (please include steps for implementation, benefits, etc):

If you would like to discuss your experience with us, please complete the following:

Name:
Phone:
Email: