Social Services would love to hear your opinion!

Filling out this survey will not affect the services you get. 

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* 1. Today's Date 

Date

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* 2. Please mark your answer about the service you received:

  Yes No Doesn't Apply to Me
Drivers are on time.
Drivers are courteous and respectful.
Staff answered my questions.
Staff were sensitive to my cultural/ethnic background.
I am satisfied with the service I received.
I will recommend this service to others.

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* 3. If you had not used our service, how would you have reached your destination?

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* 4. What did you like best about the services you received?

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* 5. How can we make our services better?

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* 6. Does your household have any unmet needs? If yes, what are your needs?

You don't have to answer, but it would help us to know:

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* 7. What is your gender?

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* 8. What is your age?

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* 9. Race/Ethnicity/Culture (Check all that apply):

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* 10. Would you like to talk with a staff member about your feedback? If so, give us your name and contact information. We will get back to you within 10 business days.

Thank you for your valuable time and input. Your opinion and feedback will help make sure that we provide the highest quality services to our community!

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