WCHS Customer Survey English Wake County Human Services Customer Survey Please tell us about your visit today. Choose or fill in your answers below. Thank you. OK Question Title * 1. What Month is this being keyed in? 01-Jan 02-Feb 03-Mar 04-Apr 05-May 06-Jun 07-Jul 08-Aug 09-Sep 10-Oct 11-Nov 12-Dec OK Question Title * 2. Language English Spanish OK Question Title * 3. Which Center did you visit? Corner Stone Eastern Regional Center Millbrook Human Service Center Northern Regional Center South Wilmington Street Center Southern Regional Center Sunnybrook Swinburne Waverly Akins Wake County Office Building Western Wake Human Service Center Wake House OK Question Title * 4. Name (Optional) OK Question Title * 5. Date OK Question Title * 6. What Service program did you use today? OK Question Title * 7. Rate the quality of the customer service you got from staff Excellent Very Good Good Fair Poor OK Question Title * 8. How many people came with you? 0 1 2 3 4 5 or more OK Question Title * 9. Rate your satisfaction with the operating hours of the center that you visited. Very satisfied Satisfied Not Sure Dissatisfied Very dissatisfied OK Question Title * 10. Would you use extended service hours if we opened earlier, closed later or opened on the weekends? Yes No OK Question Title * 11. Check all the extended hours you would use: Earlier Hours Later Hours Weekend Hours OK Question Title * 12. Check all the areas where we could improve your customer experience: Making an appointment Check-In Talking with staff about my case Waiting Time OK Question Title * 13. Did you get the information you needed? Yes No OK Question Title * 14. Rate the overall condition of the building you visited today Excellent Very Good Good Fair Poor OK Question Title * 15. Rate your overall satisfaction with Wake County Human Services. Very satisfied Satisfied Not Sure Dissatisfied Very dissatisfied OK Question Title * 16. How long have you lived in Wake County Less than 1 year 1 to 3 years 3 to 6 years 6 years or more OK Question Title * 17. May we contact you? Yes No OK Question Title * 18. If yes to above please share your phone and/or email OK Question Title * 19. Do you have any other suggestions for improvement? OK DONE