Customer Service Satisfaction Survey
1) What office did you interact with today?
2) Date of visit: (Format MM/DD/YYYY)
3) Name of County Representative:
4) What type of service or information were you seeking?
5) During your interaction with us, our representative(s) first contacted you within a reasonable amount of time.
Yes
No
6) If not, how long did you have to wait?
7) Our representative(s) resolved the issue in a timely manner.
 Strongly Agree
 Agree
 Disagree
 Strongly Disagree
8) Our representative(s) were knowledgeable.
 Strongly Agree
 Agree
 Disagree
 Strongly Disagree
9) Our representative(s) were courteous.
 Strongly Agree
 Agree
 Disagree
 Strongly Disagree
10) Our representative(s) resolved the issue to your satisfaction.
 Strongly Agree
 Agree
 Disagree
 Strongly Disagree
11) Our representative(s) explained why your issue/request could not be resolved to your satisfaction or offered alternative solutions to solve it.
 Yes
 No
 Not Applicable
12) Our representative(s) presented a professional appearance?
Yes
No
13) How would you rate our service overall?
 Excellent
 Good
 Acceptable
 Poor
14) May we use your comments in our web site or other publications?
Yes
No
15) May we contact you?
Yes
No
16) Name:
17) Address:
18) Telephone:
19) Email:
20) Additional Comments: