Point Of Service Survey

Name:

Your Email:

Date of Service:

Type of Service: General Assistance Specific Deadline Advice/Counsel Policy/Procedure

1. Was the individual accessible?

   Not at all Somewhat Very
2. Was the individual responsive?

   Not at all Somewhat Very
3. Was professionalism and courtesy shown?

   Not at all Somewhat Very
4. Did the individual provide clear/appropriate options?

   Not at all Somewhat Very
5. Overall, were you satisfied with the customer service provided?

   Not at all Somewhat Very

Additional Comments: