Child Support Enforcement Customer Service Survey

We want to know your opinion about our services. Please complete this Survey and submit it. Your response is very important to us. We will not be asking you to identify yourself on the Survey, but you may do so if you desire an answer back. Thank you.

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* 1. Today's date:

Date

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* 2. Your age group:

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* 3. Race/Ethnicity:

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* 4. Gender:

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* 5. Which Service Area(s) did you most recently visit in person?

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* 6. Did you have an appointment in this area?

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* 7. What amount of time did you wait to be seen by a representative?

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* 8. Do you feel your questions/concerns were adequately addressed and answered?

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* 9. I feel the Agency representative treated me with dignity and respect.

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* 10. I feel the Agency representative was sensitive to my culture.

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* 11. I had the opportunity to share my concerns.

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* 12. I understand my rights, responsibilities and obligations as pertains to my child support case.

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* 13. The amount of time I have had a case with the Agency:

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* 14. I feel the child support representative was concerned with helping me.

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* 15. The child support representative explained the actions taken on my case.

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* 16. The agency environment was safe & confidential.

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* 17. I was able to interact with the agency in a manner that did not interfere with my work schedule.

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* 18. Is there anything else you want to tell us about your agency visit? Please provide comments, suggestions, explanations, positive experiences, etc.

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