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Consumer Satisfaction
*
1.
What program area are you evaluating? Note: Only one program may be evaluated at a time.
(Required.)
Public Assistance
Child Support
Workforce/OhioMeansJobs (includes Child Care and Work Activities)
Social Services (Child and Adult Protection, Supportive Services, Adoption)
General (i.e. Front Desk)
2.
Do you know your case number?
Yes
No
3.
If Yes, enter your case number here.
4.
Please rate the agency's response to your questions/concerns/case status and next steps.
1 star
2 stars
3 stars
4 stars
5 stars
5.
Please share any positive comments you have regarding your recent interactions with the agency.
6.
Please share any feedback/suggestions you have based on your recent interactions with the agency.
7.
Would you like a representative to contact you regarding your experiences with the agency?
Yes
No
8.
If yes, please provide your name and phone number so we may contact you.
Name
Phone Number
