Customer Satisfaction Survey

This survey is voluntary and completely confidential. the results of this survey will be used to improve your overall experience, as well as the programs and services like the ones you received from NWCSA.

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* 1. Please input date.

Date / Time

Date

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* 2. County

Other (please specify)

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* 3. Are you a

Other (please specify)

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* 4. Services you have received or participated in (check all that apply)

Housing

Food Pantry

Homeless Shelters

Volunteer Income Tax Assistance Program

RSVP

Lew Martin Senior Center

Memory Lane

WIC

Other (please specify)

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* 5. On a scale of 1 to 5 (with 1 being very low and 5 being very high), how would you rate the following statements about your experience with NWCSA: The people at NWCSA treated me with respect.

Very Low

Very High

Very Low

Very High

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* 6. On a scale of 1 to 5 (with 1 being very low and 5 being very high), how would you rate the following statements about your experience with NWCSA: The people at NWCSA were helpful.

Very Low

Very High

Very Low

Very High

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* 7. On a scale of 1 to 5 (with 1 being very low and 5 being very high), how would you rate the following statements about your experience with NWCSA: The people at NWCSA helped me in a timely manner.

Very Low

Very High

Very Low

Very High

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* 8. On a scale of 1 to 5 (with 1 being very low and 5 being very high), how would you rate the following statements about your experience with NWCSA: The people at NWCSA provided me with services that met my needs.

Very Low

Very High

Very Low

Very High

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* 9. Do you have any other comments, questions, or concerns? Feel free to share any comments or concerns you may have about your experience. If you have no comments, please leave blank.