Clinic Feedback Survey
It has been our pleasure to deliver a Brady and Associates Inc. health promotion initiative, the Corporate Flu Clinic Program, to the employees of your organization. We are committed to providing our clients with the highest level of service possible. To this end, we would greatly appreciate if you could take a few minutes to complete the following questionnaire. Your feedback will help us to continually improve the service we provide.
Did other members of your family get the Flu shot? Did they have a healthy Flu season? |
|||
If your children were vaccinated last year, where did they get the Flu shot? Public clinic Doctor's office School Other: |
If given the option, where would you prefer to take your child to be vaccinated? Work School Doctor's office Public clinic Other: |
||
Why do you get the Flu shot? Convenience Health security Concern about lost-time at work Other: |
To your knowledge, did any of your colleagues take time off last year due to Flu-related illness? |
||
To your knowledge, did any of your colleagues that GOT the shot get the Flu? |
From your perspective, did you feel more personal health security knowing that your workplace was vaccinated against the Flu? |
||
This Year... |
|||
1. How satisfied were you with the service? Not at All Indifferent Satisfied Very Satisfied |
2. How would you rate the information provided to the participating employees prior to receiving the vaccination? Poor Fair Good Excellent |
||
3. How would you describe the service delivery on clinic day? Organized Professional Equipped to handle an emergency situation Helpful in answering employee’s questions |
4. Please indicate your impression of the benefits of our Corporate Flu Vaccination Program: Endorses health promotion Educates employees Demonstrates commitment to employee health |
||
Next Year... |
|||
Would you get a Flu shot next year if it were offered at your workplace? |
Would you get a Flu shot elsewhere if it were NOT offered at your workplace next year? |
||
If given the option to bring your family members to your workplace clinic would you accept? If yes, what is your strongest reason? Convenience Less exposure to public illness Less wait time Other: |
How would you suggest that we improve our service during next year’s Flu season? |
||
Thank you for your time. |
|||
Name: |
Organization: |
Submit your form: