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: