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DOH GILGIL CUSTOMER SATISFACTION SURVEY
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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DOH GILGIL CUSTOMER SATISFACTION SURVEY
1
Whats your age range
Select one answer
18-30
30-40
41-50
51-60
Above 60
Other (please specify)
2
What's your sex
Select one or more answers
Male
Female
Others
3
How far is your place of residence
Select one or more answers
1-5 Kms
> 5 Kms
4
What services did you get from the facility
Select one or more answers
Outpatient general services
Family planning services
Child Welfare Services (Growth monitoring, deworming, immunization, Vit A Supplementation)
HIV Testing, Care and Treatment
TB Screening and management
Other (please specify)
5
Were you charged for services
Select one or more answers
Yes
No
6
On a scale of 1-5, rate the general quality of services provided
Use digits only
7
Were you served with respect, privacy and confidentiality
Select one answer
Yes
No
8
What proportion of the drugs prescribed were dispensed?
Use digits only
9
What proportion of prescribed drugs and non-pharms are in the Kenya Essential Medicines List (2023)
Use digits only
10
What services are currently unavailable and you would wish to get from the facility
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