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
   Disgree
   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: