To pick up WIC checks only

To be certified for WIC (Nutritionist Appointment) AND receive WIC checks

To get information on WIC or to make an appointment only

Other (specify)

Please check one box per line to rate the WIC program:

	Excellent	Fair	Needs Improvement	N/A
Check Issuance
Courteous Service
Waiting Time
Nutrition Information
Answered my questions

The WIC staff is easy to reach by telephone:

Always    Usually    Very hard to reach (frequently busy / answering machine)

I left a message with WIC and was:  Called back promptly    NOT called back promptly

Do you have Internet access at home?   Yes   No 

Do you need WIC to be open additional hours?   Yes   No    

If yes, please indicate the times / days needed:

Did you have problems getting to our office?   Yes   No

If yes, please explain:

How can we improve our service?  Any other comments?

To submit your survey, please enter the number you see in the box and click submit.