HEAP Customer Satisfaction Questionnaire Question Title * 1. What service(s) did you receive assistance in? HEAP (Utility Assistance) Emergency Services (rent, gas cards, hygiene/cleaning kits, transportation) HWAP (Weatherization) Referred to another program Question Title * 2. If you did not receive assistance or needed further assistance, did the agency provide additional resources? Yes No additional services were needed If yes, what other services were needed: Question Title * 3. How did you hear about our services or programs? word of mouth (ex. a friend, family member, or neighbor) past experience with our office website/social media referred by another agency If Other (please specify) Question Title * 4. Were the resources you needed available and easy to access? Yes No Question Title * 5. Would you recommend our services to a friend or family member? Yes No Question Title * 6. How responsive have we been to your questions or concerns about our services? Extremely responsive Very responsive Somewhat responsive Not so responsive Not at all responsive Question Title * 7. Overall, how would you rate the quality of your customer service? Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied Question Title * 8. What could we do better? Is there anything else we could do to better serve you or the community? Question Title * 9. Optional: Would you be interested in sharing your personal story with us? If yes, please provide your name and contact information below Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number Done