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Injury Prevention Program

Injury Prevention Program Website Satisfaction Survey

Quality in a service or product is not what we put into it, it is what our customers get out of it. Are we meeting your expectations?

Thank you for visiting the Injury Prevention Program website. Please take a moment to complete this brief survey. Your feedback is important to us and will help us improve the website to meet your needs. All responses are confidential and will be used solely to improve service.

To protect your privacy, please do not disclose or share any sensitive or confidential health and financial related information within this form.

Getting to the Website

It was easy to find the Injury Prevention Program website.
Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable

How did you navigate to the Injury Prevention Program website?
Typed in the web address
From www.MyFlorida.com
From www.doh.state.fl.us (Department of Health)
Search engine (E.g. Google or Yahoo)
Other:

If you used a search engine, what key words did you use for the search?

Website Content

What is the main reason for your visit to the Injury Prevention Program website? (E.g. data, program information, etc.)

I was able to find the information or service I needed on the Injury Prevention Program website.
Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable

If you answered "disagree," or "strongly disagree," please describe what information you could not find on the website, so that we can improve. Please be specific.

The information provided was clear and understandable.
Strongly Agree
Agree
Disagree
Strongly Disagree
Not Applicable

How would you rate the Injury Prevention Program website overall?
Excellent
Good
Fair
Poor

Please provide any other comments or suggestions for improving the Injury Prevention Program website. Please be specific.

Demographic Information

Are you a Florida Resident?
Yes
No

Please tell us which kind of customer you are.
Federal Agency
Injury Prevention Advocacy Group
Law Enforcement
Lay Person or Injury Victim/Survivor
Local Government
Medical Personnel
Non-Profit Organization
State Government
University System, Research Facility or Health Education Center
Other:

Contact Information

If you would like to be contacted about your responses, please include your name and email address below and we will respond to you soon. Thank you.

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this program by phone or in writing.

Name: 
Email: 

Please enter the text shown below.

If you have any concerns you wish to discuss, please feel free to contact the Director of the Injury Prevention Program, Lisa VanderWerf-Hourigan, at (850)245-4440 ext. 2776.


Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this program by phone or in writing.

Injury Prevention Program
4052 Bald Cypress Way, Bin A22 | Tallahassee, FL 32399-1722
Phone: 850.245.4440 | Fax: 850.414.6470

For general comments, questions, or concerns about this site, please email the web manager.
This page was last modified on: 08/31/2012 09:44:30