HelpLine Consumer Satisfaction Survey

1.

HELPLINE OF DELAWARE AND MORROW COUNTIES CONSUMER SATISFACTION SURVEY

Please take a few minutes to answer the following questions so HelpLine may better serve the community.

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* 1. Did you speak to a HelpLine worker:

on the phone?

in person?

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* 2. When speaking with the HelpLine worker, were you given other agencies or organizations to contact?

Yes

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* 3. If you were given referrals, did you contact them or do you plan to contact them in the future?

Yes

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* 4. How would you rate your overall satisfaction with the services that HelpLine provided?

	Not Helpful				Very Helpful	N/A
Choose one:	Choose one: Not Helpful	Choose one:	Choose one:	Choose one:	Choose one: Very Helpful	Choose one: N/A

If not helpful, what would have been useful?

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* 5. Would you like to offer any suggestions on how the agency might be able to provide better services to the community and/or raise community awareness about our services?

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* 6. County and State of Residence

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* 7. Would you be willing to share your story with the public for the purpose of educating the public of our services?

Name

Contact Information