We are pleased that you have visited the Veterans Affairs Office and now are asking for your help. Please take a few minutes to answer some questions about our service. Your suggestions and opinions are important to us. The responses will be evaluated and changes or improvements will be made in an effort to provide you with better services. Your responses will be kept completely confidential. Thanks for your participation!


Tell us about you...

* 1. Your Age:

* 2. Gender:

* 3. Ethnic background:

* 4. Is English your first language?

* 5. Where did you receive the service(s)?

* 6. Please rate your level of agreement with the statements regarding Veterans Affairs Office service(s) according to the scale below. Leaving an answer space blank means "Not Applicable".

  Strongly disagree Disagree Neither agree/disagree Agree Strongly agree
I was treated courteously by the staff.
The staff was attentive to my needs.
The staff was knowledgeable and able to answer my questions.
The assistance I received from this department was useful.
The office hours were convenient to meet my needs.
Overall, I am satisfied with the services I received.
I feel comfortable returning for additional services if I need them.
The time spent waiting for service was reasonable.

* 7. How did you learn of the service(s)?

* 8. What did you like best about the service you received in our office?

* 9. What suggestions would you make to improve the quality of our services?

* 10. If you would like someone to contact you about your concerns, please feel free to leave your name, telephone number and/or e-mail. (Optional)

Thank you for taking the survey!

T