PATA Client Satisfaction Scorecard

INTRODUCTION
At this health facility we are dedicated to ensuring that young people like yourself feel comfortable and well cared for. That's why we want to hear from you about your experiences with us. If you're between the ages of 10-24 years, please fill out this scorecard to let us know how we're doing.
Your answers will help us improve our services and make sure we're meeting your needs. You don't have to tell us your name; all your answers will be kept private.
Read each question and mark the answer that comes closest to how you feel. Thanks for helping us make our health facility better for you and other adolescents and young people

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1. Enter date

2. Country

3. Facility

4. Do you agree to complete this client satisfaction scorecard? (Please tick one) *

5. Age (Enter your age)

6. How would you like us to address you? (Please tick one)