Cheyenne-Laramie County Health Department Customer Survey

Please provide your ZIP code:

Question Title

* 1. Please provide your ZIP code:

Date of Service?

Question Title

* 2. Date of Service?

Date
Which division did you contact?

Question Title

* 3. Which division did you contact?

Briefly describe services provided

Question Title

* 4. Briefly describe services provided

Please rate our staff of the following, where A= Excellent and F= Poor.

Question Title

* 5. Please rate our staff of the following, where A= Excellent and F= Poor.

  A B C D F
Respectful
Knowledgeable
Professional
Friendly
How well did our staff do the following, where A = Excellent and F = Poor

Question Title

* 6. How well did our staff do the following, where A = Excellent and F = Poor

  A B C D F
Communicate information clearly
Listen to your concern
Respond in a timely manner
Please rate your overall experience with our department

Question Title

* 7. Please rate your overall experience with our department

Please provide any additional comments, information, and/or suggestions.

Question Title

* 8. Please provide any additional comments, information, and/or suggestions.

T