Customer Satisfaction Survey FY25
Thank you for your participation. Your feedback is very important to us.
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1.
Please choose the services you applied for. Please check all that apply.
Case Management
CHANCE
Early Head Start
Head Start
Housing Connect
Housing Voucher
Intake, Assessment and Referral
Property Tax Credit
Temporary Rental Assistance
Utility Assistance
Weatherization
Home Repair
Seeking information only
Other (please specify)
2.
Did you receive assistance for the services you applied for?
Yes
No
Pending
Referred to other community resources
Placed on waiting list
I must provide more documentation to be placed on the waiting list
3.
Please choose your type of visit.
Phone call
Virtual visit
Mail-In
In-Person visit
4.
Please rate your experience, were you?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Very dissatisfied
Somewhat dissatisfied
If you were not satisfied, please explain why:
5.
How satisfied were you with the responsiveness to your needs and/or questions and concerns?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Very dissatisfied
Somewhat dissatisfied
If you were not satisfied, please explain why:
6.
How satisfied were you with the facility you applied/received services in?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Very dissatisfied
Somewhat dissatisfied
N/A
If you were not satisfied, please explain why:
7.
How likely are you to return when you need assistance?
Very likely
Somewhat likely
Not likely
Neither likely nor unlikely
I would not return
If you would not return, please explain why:
8.
What could we have done better to help with your experience at ESC?
9.
How did you hear about our agency? Please select all that apply.
Friends or Family
Twitter
Television
Facebook
Brochure
Newspaper
ESC website
Flyer
Tear-off pad
Radio
Another Agency
Other (Please specify)
10.
In which county do you live in?
Barton
Jasper
McDonald
Newton
11.
How likely would you be to recommend our service to others?
Very likely
Somewhat likely
Not likely
Neither likely nor unlikely
I would not recommend
Please tell us why you would not recommend:
12.
Are there any additional comments you would like to make? Please do so below:
Yes
No
Additional Comments:
13.
If you would like us to follow up with an issue you had, please provide your name, phone number, and/or email address:
Current Progress,
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