Significance: This study addressed cultural issues related to the use of health services provided by Shamans (traditional healers) among Hmong populations. The purpose of this study was to gain an understanding of (1)the role of the gender of shamans, (2)the use of live or dead animals in the healing ceremony of shamans, and (3)the location of the ritual ceremony, as they affected satisfaction levels among Hmong clients living in a rural area of California. Design: This study involved the completion of an 18-item questionnaire related to customer satisfaction with health services provided by shamans. A total of 115 participants answered the survey instrument. Data collection was gathered through an oral interview for those participants who did not read or write. Reliability and validity of the instrument were ensured thorugh the a pilot testing phase. Three hypotheses were tested using SPSS. Data were analyzed through ANOVA, T-Test for independent samples, and Chi-Square. Results: A significant difference (p<.05) in clients’ satisfaction levels was found by the shamans’ practice inside or outside the client’s home. A significant difference was found in clients’ satisfaction according to the use of live or dead animals in the shaman’s practice. Clients who had shamans who use live animals were significantly more satisfied than those who use dead animals. There were no significant differences in regard to the gender of shamans. Keyword(s): diversity, research, wellness/disease prevention