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Please tell us a little about yourself
I am a(n)....
Student Employee Other (Vendor, Guest, Friend/ Family)
I am a.... Female Male
I am... Under 18 years old
50+ years old
18-25 years old 26-49 years old
Please take a few minutes and provide your feedback. Your constructive criticism is important to us, and your feedback will be used to improve our service to you.
Is the Student Health Center your only resource for obtaining health care?
Yes No
Approximately, how many times a semester do you visit the Health Center?
1 Time 2 - 4 Times More than 4
Times
Identify two (2) immunizations you must have documented proof of to transfer to a four-year school.
Hepatitis B Tetanus MMR (Measles/Mumps/Rubella) TB (Tuberculosis Skin Test)
Does the Student Health Center assist you staying in school and succeeding?
Yes No
Would you recommend the Student Health Center to other students?
Yes No
Will you continue to use the Student Health Center at
Moorpark College?
If not, why?
Yes No
Class Climate STUDENT HEALTH CENTER Student Satisfaction Survey [Copy]
Please take a few minutes and provide your feedback. Your constructive criticism is important to us, and your feedback will be used to improve our service to you. [Continue]
I use the Student Health Center because.... (Select all that apply)
I have other insurance, but the Student Health Center is less expensive to use.
I don't have other insurance. It is located on campus.
I can arrange appointments around my classes.
Other (specify below).
It offers immediate care. It offers the services I need.
How did you hear about the Student Health Center? (Select all that apply)
Another Student / Campus Event / CounselorClass Presentation / Flyer / Instructor
Portal / Other (specify below)
Please indicate your level of agreement with each of the following statements.
Strongly Agree Strongly
Disagree
I felt safe during my visit to the Health Center today
I learned how to better take care of myself
I was seen in a timely manner
I was given information to help me take better care of myself
I was treated with respect
I felt heard and taken seriously during my visit to the Health
Center today
I was treated courteously by the staff
Staff members were attentive to my needs
The provider (doctor/nurse) explained the nature of my illness/
condition in understandable terms
The treatment and health instructions were explained clearly
The provider made time to listen to and answer all of my questions
I feel that the treatment offered was appropriate for my illness/
condition
Please use the space below to offer suggestions on how we can better serve our clients. Feel free to comment on convenience of appointments, fees, health education material, etc.