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? (Required.)

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3. Did CAPSBC staff clearly outline the eligibility requirements to obtain service(s)? If weatherization services were requested, did CAPSBC staff clearly outline the weatherization process? (Required.)

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4. Did you receive the service(s) you were seeking from CAPSBC? (Required.)

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5. What CAPSBC program were you assisted with? Please select all that apply. (Required.)

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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? (Required.)

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

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9. Please rate the quality of service you received. (Required.)

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

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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)? (Required.)

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

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

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

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