Survey

Thank you for visiting the Health Information Center. Your opinions are very important to us.
To maintain the quality of services at the Center, we need your help in completing this survey.


1).  I found the information I wanted.                        Yes No

2).  The following information was helpful:

Health video                                        Yes No Not applicable
Printed materials                                  
Yes No Not applicable
Internet health information                        
Yes No Not applicable

3).  The homepage is easy to navigate.                        Yes No

4).  I am interested in the following additional health topics:

Health video                   Yes    If yes, what topic?    
                              
No  
Print materials               
Yes    If yes, what topic?    
                             
No
Internet health information  
Yes    If yes, what topic?    
                             
No
Class on asthma              
Yes    If yes, please describe 
                             
No
Class on cancer               
Yes    If yes, please describe
                              
No
Class on diabetes            
Yes    If yes, please describe
                             
No
Class on heart diseases      
Yes    If yes, please describe
                             
No
Other                         
Yes    If yes, please describe
                              
No

5).  I prefer the health information in:     Spanish English Chinese Vietnamese

6).  I am:  Hispanic African-American Caucasian Asian/Pacific Island Other

7).  My gender is:      Female Male

8).  My age is:         less than 20 years 20-29 30-39 40-49 50-59 60 plus

9).  The staff were helpful in meeting my needs.       Yes No Not applicable

10). What Health Information Center did you visit?    Kelsey-Seybold Clinic Main Campus
                                                     
Kelsey-Seybold Clinic West
                                                     
Kelsey-Seybold Clinic Ft. Bend Medical and Diagnostic Center
                                                     
Neighborhood Centers Inc. - Harbach-Ripley Youth Center
                                           Neighborhood Centers Inc. - Independence Heights
                                                     
Neighborhood Centers Inc. - Ripley House


Copyright © 2006 Kelsey Research Organization. All rights reserved.
Revised: 12/28/06