Self-Help Center Customer Satisfaction SurveySelf-Help Center Customer Satisfaction Survey

1. Date and time of arrival:

	MM		DD		YYYY		HH		MM	AM/PM
Date / Time:	Date and time of arrival: Date / Time: Month	/	Day	/	Year		Hour	:	Minute	AM or PM

2. Did you meet with a Self Help Center volunteer attorney?

Did you meet with a Self Help Center volunteer attorney? Yes

3. How did you find out about the Self Help Center?

How did you find out about the Self Help Center? Internet

Friend

Attorney

Clerk's Office

Bankruptcy Court Notice

Judge (Please indicate Judge's name in comment field below)

Other (Please specify in comment field below)

Comment

4. Which of the following resources, if any, will you use to answer additional questions you might have in the future? (check all that apply)

Which of the following resources, if any, will you use to answer additional questions you might have in the future? (check all that apply) Website: www.azb.uscourts.gov Self Help Center Forms	Website: www.azlawhelp.org Attorney	Bankruptcy Basics program None of the above
Other (please specify)

5. Did the Self Help Center staff or attorney refer you to outside resources or agencies that could help you?

Did the Self Help Center staff or attorney refer you to outside resources or agencies that could help you? Yes	No
If you answered "Yes", which agencies or resources were you referred to?

6. Please rate the quality of the service you recieved today:

	Poor				Excellent
The information I recieved was...	*Please rate the quality of the service you recieved today: The information I recieved was... Poor	The information I recieved was...	The information I recieved was...	The information I recieved was...	The information I recieved was... Excellent
The Bankruptcy Basics computer presentation was...	The Bankruptcy Basics computer presentation was... Poor	The Bankruptcy Basics computer presentation was...	The Bankruptcy Basics computer presentation was...	The Bankruptcy Basics computer presentation was...	The Bankruptcy Basics computer presentation was... Excellent
Compared to when I came in, my understanding of how to handle my case is...	Compared to when I came in, my understanding of how to handle my case is... Poor	Compared to when I came in, my understanding of how to handle my case is...	Compared to when I came in, my understanding of how to handle my case is...	Compared to when I came in, my understanding of how to handle my case is...	Compared to when I came in, my understanding of how to handle my case is... Excellent
Compared to when I came in, my ability to find helpful information in the future is...	Compared to when I came in, my ability to find helpful information in the future is... Poor	Compared to when I came in, my ability to find helpful information in the future is...	Compared to when I came in, my ability to find helpful information in the future is...	Compared to when I came in, my ability to find helpful information in the future is...	Compared to when I came in, my ability to find helpful information in the future is... Excellent
The Court employees (not the volunteer lawyer) provided me with educational resources.	The Court employees (not the volunteer lawyer) provided me with educational resources. Poor	The Court employees (not the volunteer lawyer) provided me with educational resources.	The Court employees (not the volunteer lawyer) provided me with educational resources.	The Court employees (not the volunteer lawyer) provided me with educational resources.	The Court employees (not the volunteer lawyer) provided me with educational resources. Excellent
I believe my ability to retain a lawyer in my case is...	I believe my ability to retain a lawyer in my case is... Poor	I believe my ability to retain a lawyer in my case is...	I believe my ability to retain a lawyer in my case is...	I believe my ability to retain a lawyer in my case is...	I believe my ability to retain a lawyer in my case is... Excellent
The way I was treated by Court employees (not the volunteer lawyer) was...	The way I was treated by Court employees (not the volunteer lawyer) was... Poor	The way I was treated by Court employees (not the volunteer lawyer) was...	The way I was treated by Court employees (not the volunteer lawyer) was...	The way I was treated by Court employees (not the volunteer lawyer) was...	The way I was treated by Court employees (not the volunteer lawyer) was... Excellent
Overall, my experience in the Self Help Center was...	Overall, my experience in the Self Help Center was... Poor	Overall, my experience in the Self Help Center was...	Overall, my experience in the Self Help Center was...	Overall, my experience in the Self Help Center was...	Overall, my experience in the Self Help Center was... Excellent

7. What could we do to improve the service we provide?

What could we do to improve the service we provide?