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1. How satisfied are you with the timeliness of our application processing?

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2. Did we call you at your scheduled appointment time?

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3. How well were your questions answered during your interaction?

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4. Did you feel respected during your interaction with our staff?

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5. Do you have any additional comments or suggestions?

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6. How did you hear about our energy assistance program? Select all that apply.

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7. Please provide your name (optional):

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9. Please provide your telephone number (optional):

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10. What agency did you work with?

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