1. Valued Customer,

17% of survey complete.

Would you please take a moment to tell us how you feel about the service (s) you received?
Your comments will help us to ensure we are meeting a high standard of excellence.

* 1. Date of Survey:

Enter Full Date

* 2. How did you hear about the program services you received?

* 3. Did CAPSBC staff clearly outline the eligibility requirements to obtain service (s)?

* 4. Was the process for obtaining services clearly conveyed to you by CAPSBC Staff?

* 5. Did you receive the service (s) you were seeking on your first visit

* 6. If your answer was "NO" to the previous question, please provide the reason why?

* 7. What CAPSBC program were you assisted with? If assisted with more than one service below, please fill out a separate survey for each instance.