Customer Satisfaction Survey | Online Services || Riverside County Transportation & Land Management Agency

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Last Updated

4/13/2009

* Denotes Required Fields

At what location did you receive service?*

Enter location name: Select Floor #: Rate Our Phone Service

Which division assisted you?
	Enter Division name*:

When did you receive assistance?*
Date*: (ex: 11-APR-05)	Time:
Was the wait/response time acceptable?	Yes No

What was the purpose of your visit? (1000 character limit)
0 characters

Are you the:

Did our staff:
Identify themselves or wear a name tag:	Yes No
Offer you a business card:	Yes No

Was the information/ instruction given to you concerning your project clear, concise and consistent?
Yes No

Were you able to accomplish your goal?
Yes No

If you used our website, did you find it helpful in achieving your goals?
Yes No

If problems arose, were you offered any options or alternatives?
Yes No

Please rate your the overall service you received?
HIGH	5 4 3 2 1	LOW

If you could make one improvement to our service what would it be? (1000 character limit)
0 characters

If you would like to be contacted, please fill out the information below:
How do you wish to be contacted?	E-Mail	Mail	Phone

Name*:
Address Line 1*:
Address Line 2:
City*:
State*:
Zip*:

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