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Wellness Center Web Forms

Wellness Center Web Forms

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Mount St. Joseph University
Health Services Client Survey

This survey is given to obtain your feedback regarding your recent visit in Health Services. Our goal is to improve our services. This survey is anonymous and completely confidential. We very much appreciate your participation in this survey. Thank you.

Please provide the following information regarding yourself and your visit:

Year in school:

Year in school:

I would describe myself in the following manner (select all that apply):

I would describe myself in the following manner (select all that apply):

I had an appointment for today’s visit.

I had an appointment for today’s visit.

How long did you wait to be seen for your visit?

How long did you wait to be seen for your visit?

I saw the following Health Care Provider (select all that apply):

I saw the following Health Care Provider (select all that apply):

Information was provided concerning my condition including how to care for my illness or injury and the likely recovery time.

I was instructed what to do if my symptoms worsened or did not go away completely.

I was provided with information on how to prevent future illness and/or injury.

If medication was provided or prescribed-
I was told what the medication was for, possible side effects and how to take it.

The staff in Health Services was courteous and respectful.

My visit to Health Services has increased my confidence and ability to care for my medical needs.

The staff Health Services (and/or the Wellness Center) have helped me be successful in my classes, sports or work.

The staff in Health Services (and/or the Wellness Center) helped me stay enrolled at Mount St. Joseph University this semester.

I would return to Health Service in the future if needed.

Overall I am satisfied with my experience in Health Services.

The prices in Health Services are just right.

If you answered “Strongly Disagree” or “Disagree” to any of the above statements, please briefly explain the reason for your dissatisfaction:

Please share any additional thoughts on how Health Service can improve services provided to students:

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