Thank you for taking the time to complete this survey. Please answer the following questions to the best of your ability.

Gracias por tomar el tiempo para responder a esta encuesta. Por favor conteste las siguientes preguntas lo mejor que pueda.

Date you Received Care
January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029

Please enter your responses below:

Por favor marque sus respuestas en las siguientes preguntas:

1. Were you assisted in a timely fashion? Were you assisted in a timely fashion?

   Very Good Muy bueno

   Good Bueno

   Fair Regular

   Poor Malo

   Very Poor Muy malo

   n/a n/a

2. Ease in getting questions answered? Ease in getting questions answered?

   Very Good Muy bueno

   Good Bueno

   Fair Regular

   Poor Malo

   Very Poor Muy malo

   n/a n/a

3. Assistance from Business Office Staff courteous and helpful. Asistencia del personal, cortes y servicial.

   Very Good Muy bueno

   Good Bueno

   Fair Regular

   Poor Malo

   Very Poor Muy malo

   n/a n/a

4. Comments: (describe good and bad experience and suggestions for improvement) Comentarios: (describir buenas y malas experiencias y sugerencias de mejorar)