Customer Satisfaction Survey OUR CORE VALUES CARE * COMMITMENT * CUSTOMER SERVICE This survey is used to help us evaluate customer service experiences, and your feedback is greatly appreciated. If you have case specific questions, please contact us at 866-901-3212 or email to smcdcss@smcgov.org OK Question Title * 1. CASE # (Required.) OK Question Title * 2. NAME (Required.) OK Question Title * 3. DATE SERVICES PROVIDED (Required.) OK Question Title * 4. WHAT IS YOUR RELATIONSHIP TO THIS CASE? (Required.) I pay child support I receive child support Other OK Question Title * 5. HOW DID YOU CONTACT US? (Required.) Telephone In person E-mail OK Question Title * 6. RESPONSE TIME / AVAILABILITY OF STAFF: I WAS SEEN WITHIN 15 MINUTES IN THE LOBBY/MY EMAIL WAS RESPONDED TO WITHIN 2 BUSINESS DAYS. Poor Fair Good Excellent OK Question Title * 7. COURTESY OF STAFF: I WAS TREATED FAIRLY AND WITH RESPECT. FOLLOW UP WAS HANDLED APPROPRIATELY. Poor Fair Good Excellent OK Question Title * 8. KNOWLEDGE OF STAFF: THE WORKER WAS KNOWLEDGEABLE AND PROVIDED CLEAR DIRECTION ON NEXT STEPS. Poor Fair Good Excellent OK Question Title * 9. WHAT DID WE DO WELL DURING YOUR CONTACT? OK Question Title * 10. WHAT COULD WE HAVE DONE BETTER? OK Question Title * 11. IS THERE ANY EMPLOYEE YOU WOULD LIKE TO RECOGNIZE? OK Question Title * 12. PLEASE RATE YOUR OVERALL EXPERIENCE DURING YOUR CONTACT WITH US: (Required.) Poor Fair Good Excellent OK Question Title * 13. WHAT RACE DO YOU IDENTIFY WITH? (Required.) Asian or Asian-American Black or African-American Latino/a/x or Hispanic Native American, American Indian or Indigenous Native Hawaiian or Pacific Islander White or Caucasian Decline to state Another race, ethnicity, or tribe OK Question Title * 14. WHAT ETHNICITY DO YOU IDENTIFY WITH? (Required.) African Asian Indian/South Asian Caribbean Central American Chamorro Chinese Eastern European European Fijian Filipino Japanese Korean Mexican/Mexican-American/Chicano Middle Eastern or North African Samoan South American Tongan Vietnamese Decline to state Another ethnicity or tribe OK Question Title * 15. WHAT IS THE PRIMARY LANGUAGE YOU SPEAK? (check ONE) (Required.) English Spanish Mandarin Tagalog Somoan Tongan Decline to state Another language OK DONE
