SCHOOL AND CHILD CARE SEARCH SERVICE FEEDBACK

Please let us know what you think of the service we are providing by completing this form. If you would like us to contact you, please enter your name and other contact information.

Your Name:
Phone Number:
E-mail Address:
Are you willing to have us call you for further information?	YesNo
Do you wish us to call because you would rather explain your reactions verbally instead of through this form?	YesNo
	poor             good             excellent
How did we do at treating you with warmth, respect, and empathy?
How did we do at responding to you with efficiency and effectiveness?
Was the information we gave you accurate and helpful?
How would you rate the effectiveness of each aspect of our service?
Web Site
Publications/Handouts
Personal Interview
Telephone Communications
E-mail Communications
How satisfied are you with the results of your consultation with the SSS?
How could we improve our service?
Do you have any other comments for us to consider?