Community Health Initiative Feedback Evaluation Form
We appreciate your feedback to help us improve our community health programs.
Full Name
First Name
Last Name
Email Address
example@example.com
Please rate the overall quality of the health initiative.
1
2
3
4
5
Please rate the accessibility of the health services provided.
1
2
3
4
5
How satisfied are you with the communication from the health team?
1
2
3
4
5
What did you like most about the initiative?
What improvements would you suggest?
Would you recommend this initiative to others?
Yes
No
Maybe
Submit
Should be Empty: