Bookmark and Share

Suggestion Form

Kutztown University Health & Wellness Center Customer Service Survey

Clinical Services - Customer Service Suggestion Form


Please check one in each of the categories below that best describes you?

Undergraduate Student Graduate Student

Male Female

On-campus Off-campus



Customer Service

Please comment on the following factors:


Time waited until seen:
10 Minutes 20 Minutes 30 Minutes 30 Plus Minutes


Staff Competence:
Excellent Good Fair Poor


Accomodations: Excellent Good Fair Poor

          Self Check-In: Excellent Good Fair Poor 

          Web Appointment Process: Excellent Good Fair Poor



Please include the date/time of your visit, and your specific concern or recommended corrective action :

 


Tell us how to get in touch with you: (optional)

Name
E-mail
Tel
FAX
 
Please contact me as soon as possible regarding this matter.