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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.

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* 1. Date of Survey:

Date

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

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

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

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

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

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