You will be assisting the Lincoln County Health Department by providing useful information concerning
our service and how our service to our citizens can be enhanced. When completing this form, it is not
necessary that you provide your name or address as anonymous submissions will be accepted. When
completed, please press the Submit button, or if you prefer, print it out and mail to the address
provided at the end of the survey.

Customer Service

What was your first impression of the service you received?

Superior Very Satisfactory Average

Somewhat Unsatisfactory Poor

How long was the waiting time to see a staff member?

Superior Very Satisfactory Average

Somewhat Unsatisfactory Poor

In evaluating your most recent customer service experience, was the quality of service your received:

Superior Very Satisfactory Average

Somewhat Unsatisfactory Poor

The process of getting your problem resolved was:

Superior Very Satisfactory Average

College Graduate Somewhat Unsatisfactory Poor

I am pleased with the quality of service I received.

Very Pleased Pleased Neutral

Displeased Very Displeased

My concerns were handled during this experience.

Strongly Agree Agree Neutral

Disagree Strongly Disagree

Staff

The employee was very courteous.

Strongly Agree Agree Neutral

Disagree Strongly Disagree

The employee was very knowledgeable.

Strongly Agree Agree Neutral

Disagree Strongly Disagree

The employee outlined the steps needed to receive the service or handle the problem.

Strongly Agree Agree Neutral

Disagree Strongly Disagree

Describe the level of service received:

The employee understood & took care of the problem.

Very Helpful Average

Poor

In the question above, please explain your answer by checking all that apply from the options below:

Gave unclear answers Didn't understand the question or problem Friendly Patient Disorganized

Responsive Listened Not attentive Gave me the wrong information

If an employee provided you with especially outstanding service, please let us know his or her name.

Facilities

Was this your first visit to this facility?

Yes

No

Was the facility easy to find?

Yes

No

Were directions correct and helpful?

Yes

No

Were signs visible and helpful in locating the facility and the office needed?

Yes

No

Were you comfortable while waiting for service?

Yes

No

Was the facility clean?

Yes

No

Were other staff members helpful in locating office or employee needed for your situation?

Yes

No

Phone

Was the employee courteous and helpful when you telephoned the office or agency?

Yes

No

The employee handled my call quickly.

Strongly Agree Agree Neutral

Disagree Strongly Disagree

The phone call was quickly transferred to the person who could best assist you.

Strongly Agree Agree Neutral

Disagree Strongly Disagree

Which of the following best describes your experience when you called for information or service. Check all that apply:

Very helpful, question or problem resolved Employee referred me to the correct employee or office for service Was patient as I described my question or problem Spoke clearly & slowly Was able to provide list of items needed for service (ex. For permits) Had to ask others

I had to explain several times Didn't know how to handle the problem Kept me waiting on hold Returned to update me on wait time Other, please list below:

Agency

Which Agency is this survey for?

Medical Clinics Home Health

Environmental Health Women, Infants and Children (WIC)

What is the best method for you to get information about county services?

Newspaper Mailings Cable/TV Radio

Web Site E-Mails Other, please list below:

Contact Information

Would you like someone from
Lincoln County Health Department
to contact you?

Yes

No

If you answered yes, please provide at least one of the next two.

Telephone Number:

Email Address:

If you have any additional questions or concerns, please contact the Lincoln County Health Department Office at
at (704) 735-3001, or write to us at:
Lincoln County Health Department
Attn: Survey Response, 115 West Main Street
Lincolnton, NC 28092