Feedback Form

We value your feedback! Please share with us any comments/concerns about your visit to the Student Health Center to help us improve our service.

Please note: To ensure your privacy, do not include any personal health information, such as student id, date of birth, diagnosis or treatment on this form. If you have questions or concerns regarding your diagnosis or treatment, please call the health center and ask to speak to a provider. All feedback received with contact information provided will be entered into a monthly drawing for a $10.00 Starbucks gift card. Entries do not carryover from month to month.

* Required Fields


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How do we rate
On a scale of 1 to 5, with a 5 rating as excellent
Please do not include personal health information.
Optional Information
Please provide your contact information if you’d like to be entered into our monthly drawing.