KSU Student Health Services

470-578-6644 phone 470-578-3655 fax

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?

2) What is your overall impression of the Clinic location you visited today? (i.e. office environment, waiting time, privacy & confidentiality, etc)

3) What is your overall impression of the care and attention you received today by the Health Care Provider?

4) What is your overall impression of the care you received
today by our office staff?

5) What is your OVERALL IMPRESSION of the quality of care and services you received today?


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


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