Client Satisfaction Survey

How are we doing?

Thank you for taking time to send us your feedback! Any information you provide not only helps make our agency and staff better, it also allows us to assist the people of our community better—and that’s what it is all about.

Client Satisfaction Survey

* Required fields

Name

First Name*
Last Name*

Address

Street Address
Street Address 2
City
State / Province
Postal / Zip Code

Contact

Primary Phone*
Secondary Phone
Email*

Survey

Hold down command or control to select more than one location.
Did the site make you feel safe and welcome?
Was our staff readily available to assist you?
Was our staff courteous and polite to your needs?
Was our staff prompt in responding to your request?
Were we able to assist you with the service you requested or guide you to where you could get it?
Did the staff make you feel safe and seem approachable?
Which service or assistance did we help you with?
Other service or assistance

Feedback