Patient Experience Survey

Thank you for helping us evaluate our service by completing this survey! All responses are confidential.

Current Year
Student Status
Please select all that apply

Personal Identification

Gender
Race
Please select all that apply
Ethnicity

Experience at SHC

Please rate your experience at the Student Health Center today to help us learn where we shine and where we need to grow.

Explanation care and services from the following providers:

General

Optional: For purposes of follow-up to your comments, please provide your contact information. Responses are confidential.