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2. Thank you for giving Cochise County Health and Social Services/Vital Records the opportunity to serve you better. Please help us by taking a moment to tell us about the service you have received so far. We appreciate our relationship and want to make sure we fully meet your expectations. Simply indicate your degree of agreement with each of the statements that follow.

4. CCHSS Vital Records Registrars Are Knowledgeable

   1. Strongly Disagree
   2. Somewhat Disagree
   3. Neither Agree nor Disagree
   4. Somewhat Agree
   5. Strongly Agree
   6. N/A
6. CCHSS Vital Records Registrars Answer All of My Questions/Concerns

   1. Strongly Disagree
   2. Somewhat Disagree
   3. Neither Agree nor Disagree
   4. Somewhat Agree
   5. Strongly Agree
   6. N/A
8. I Am Happy with the Amount of Time It Took to Receive My Certified Vital Record

   1. Strongly Disagree
   2. Somewhat Disagree
   3. Neither Agree nor Disagree
   4. Somewhat Agree
   5. Strongly Agree
   6. N/A
10. Obtaining My Certified Vital Record Was Convenient

    1. Strongly Disagree
    2. Somewhat Disagree
    3. Neither Agree nor Disagree
    4. Somewhat Agree
    5. Strongly Agree
    6. N/A
12. CCHSS Vital Records Registrars Adhere to Professional Standards of Conduct

    1. Strongly Disagree
    2. Somewhat Disagree
    3. Neither Agree nor Disagree
    4. Somewhat Agree
    5. Strongly Agree
    6. N/A
14. CCHSS Vital Records Registrars Make a Positive Contribution to My Business

    1. Strongly Disagree
    2. Somewhat Disagree
    3. Neither Agree nor Disagree
    4. Somewhat Agree
    5. Strongly Agree
    6. N/A
16. CCHSS Vital Records Registrars Respond to My Inquiries in a Timely Manner

    1. Strongly Disagree
    2. Somewhat Disagree
    3. Neither Agree nor Disagree
    4. Somewhat Agree
    5. Strongly Agree
    6. N/A
18. Overall, I Am Very Satisfied with CCHSS Vital Records Registrars

    1. Strongly Disagree
    2. Somewhat Disagree
    3. Neither Agree nor Disagree
    4. Somewhat Agree
    5. Strongly Agree
    6. N/A
20. Please Indicate the Date of Your Last Interaction with a Vital Records Registrar
    Please Indicate the Date of Your Last Interaction with a Vital Records Registrar
22. Please Enter the Name of the Vital Records Registrar You Most Recently Worked with

    1. Brigitta Costello
    2. Nancy Lopez
    3. Maria Kennon
24. Please Add Any Other Comments or Suggestions You Wish to Share with Us
26. If You Wish to Be Contacted by a Member of CCHSS Management, Please Provide Us with Your Name and Phone Number or Email Address
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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