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Have you recently worked with our CHW program?

We would like to take this opportunity to thank you for your recent visit(s) with our Community Health Workers (CHWs).

In a continued effort to provide our patients with quality services, we would appreciate your opinion by answering the following questions:

Was the CHW friendly and personable?
Yes
No
Was a CHW available to you when you had a question/concern or a need?
Yes
No
In what areas did the CHW help you (click all that apply):
Did the CHW address your concerns and/or make helpful suggestions regarding any of the above-mentioned?
Yes
No
Were you connected to any other resources in the community?
Yes
No
If so, were the services provided by the other resources helpful?
Yes
No
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