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1. Valued Customer,

 
 50% of survey complete.
Would you please take a moment to tell us how you feel about the service(s) you received?
Your comments will help us to ensure we are meeting a high standard of excellence.

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* 1. Date of Survey:

Date

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* 2. How did you hear about the program services you received?

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* 3. Did CAPSBC staff clearly outline the eligibility requirements to obtain service(s)?

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* 4. Did you receive the service(s) you were seeking on your first visit

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* 5. What CAPSBC program were you assisted with? Please select all that apply.

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* 6. if you utilized our mobile service(s), please specify the site and service.

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* 7. What is the name(s) of the CAPSBC employee that helped you?

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* 8. Please rate the professionalism of the CAPSBC employee(s) that assisted you.

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* 9. Please rate the quality of service you received.

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* 10. Please rate the CAPSBC employee's ability to explain and outline the services you received.

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* 11. Once determined to be eligible for assistance, did you encounter any barriers before you could receive help (such as sitting through a speech, or sermon, attend a meeting, etc)?

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* 12. Please rate the speed of assistance in obtaining your service(s)

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* 13. Would you refer a friend or relative to CAPSBC for service(s)

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* 14. To be contacted regarding your feedback, please provide your name, phone number and email address.

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