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Weatherization Survey
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1.
How would you rate our crew member's professionalism?
(Required.)
Excellent
Satisfactory
Needs Improvement
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2.
How would you rate the quality of service you received?
(Required.)
Excellent
Satisfactory
Needs Improvement
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3.
How would you rate the speed of service you received?
(Required.)
Excellent
Satisfactory
Needs Improvement
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4.
Was the weatherization process clearly explained?
(Required.)
Excellent
Satisfactory
Needs Improvement
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5.
Did you receive the service you were originally seeking?
(Required.)
Yes
No
6.
If you answered "no" above, please check all applicable boxes below that explain why.
Service requested was beyond scope of the program
My deferral expired
I canceled/refused services
Agency canceled services
7.
Please provide any other comments or concerns
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8.
To be contacted regarding your comments, please provide your name, email and phone number.
(Required.)
Full name:
Email:
Phone number:
