Did you have a positive interaction with Town staff? Submit your feedback here.

The purpose of this form is to allow those who do business with and/or receive services from Town staff to provide positive feedback regarding their experience. This information will be provided to the supervisor of the employee so they may be acknowledged for striving to provide public service in accordance with Town Values.

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* 1. What is your name?

Full Name

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* 2. May we contact you for more information about your experience? If yes, please provide contact information below.

Phone Number:

eMail:

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* 3. Please provide the name of the staff person you wish to tell us about.

First and/or Last Name of Staff:

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* 4. Provide the date when and department or location where your interaction with Town staff occurred.

Date

Department or Location of Service (if available):

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* 5. Provide specific details regarding the behavior and/or actions you would like to share with the supervisor of the Town staff person you met.

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* 6. Briefly, please provide information about how the Town staff person exemplified one or more of the Town's Values listed below:

Respect for everyone:

Highest ethical standards:

Cooperation and teamwork:

Commitment to quality:

Spirit of Innovation:

Open, timely communication:

Personal responsibility and accountability:

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* 7. Briefly, please provide information regarding how the Town staff person behaved in a manner that supports the Town's Vision, which is: The Town of Palm Beach delivers the highest quality service by continuously improving and always striving to be the standard by which all others are measured.

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* 8. Do you have any other comments you would like to share? If so, please do so below.

Please be advised that the information submitted in the form is considered public record according to Florida State Statutes and may be provided, sans any applicable statutory exemptions, upon request.