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1. Today's date or date of service:

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2. Type of Contact:

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3. How long have you been a client of The Housing Authority of the County of Monterey?

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4. Which programs of The Housing Authority of the County of Monterey do you participate in? (Please select all that apply.)

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5. How would you rate the quality of our services?

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6. Do you have any other comments, questions, or concerns?

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7. (Optional) Your Name:

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8. Phone Number:

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9. Email:

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