Thank you for attending our Awareness Health Screening event. We strive to continually improve the level of service we provide to our customers and clients. With that goal in mind, we ask that you help us by taking a couple of minutes to complete this short survey about your Awareness Health Screening experience.

Please list your employer or location where you attended your screening appointment.
Date of your screening appointment.
Date of your screening appointment.
Please rank your agreement with the statements below.
Please rank your agreement with the statements below.
I was seen on time.
The staff member(s) who worked with me were personable and professional.
The health and wellness information provided to me was helpful and motivational.
Will you share today's screening results with your physician?
Would you like assistance with improving your health behaviors?
Please share any comments you feel would be helpful in improving our service to you next time.
If you wish, we will include your personal information with your survey results. If you decide to not share your personal information, you comments will shared as anonymous.
Would you like us to contact you?