Customer Experience Survey Customer Experience Survey Thank you for taking a moment to share your feedback. * Indicates a required field Which of our services did you use today? * In Person Self Service Tag Kiosk Website Text Messaging Phone Email OtherOther Please rate your overall experience: 1 star = Poor, 5 stars = Excellent * 1 Star 2 Stars 3 Stars 4 Stars 5 Stars How confident did you feel in our staff’s knowledge today? 1 star = Not Confident, 5 stars = Very Confident 1 Star 2 Stars 3 Stars 4 Stars 5 Stars How clearly and accurately did we answer your questions today? 1 star = Not Clear, 5 stars = Very Clear 1 Star 2 Stars 3 Stars 4 Stars 5 Stars How satisfied are you with the outcome of your visit today? 1 star = Not Satisfied, 5 stars = Very Satisfied 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please rate how promptly your call was answered. 1 star = Not Promptly, 5 stars = Very Promptly 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please rate how promptly your text was answered. 1 star = Not Promptly, 5 stars = Very Promptly 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please rate how promptly your email was answered. 1 star = Not Promptly, 5 stars = Very Promptly 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please rate the wait time for your visit. 1 star = Very Long, 5 stars = Very Short 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please rate how courteous our staff was during your visit. 1 star = Not Courteous, 5 stars = Very Courteous 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please rate how easy the kiosk was to use. 1 star = Not Easy, 5 stars = Very Easy 1 Star 2 Stars 3 Stars 4 Stars 5 Stars How likely are you to use the kiosk again? 1 star = Not Likely, 5 stars = Very Likely 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please rate how easy it was to find what you needed on our website. 1 star = Not Easy, 5 stars = Very Easy 1 Star 2 Stars 3 Stars 4 Stars 5 Stars Please note any comments or observations. File Upload Drop a file here or click to upload Choose File Maximum file size: 52.43MB Contact Information We would appreciate you providing your contact information, but it is not required. Feedback submitted through this form is part of the public record under Georgia law. Contact details such as phone numbers and email addresses would be removed before release. Names and comments may be shared upon request. Staff Member's Name Date Purpose of Visit or Call Your Name Your Phone Number Your Email Address May we contact you about your comments? Yes No Receive an email copy of this form. Receive an email copy of this form. Email address This field is not part of the form submission. Section How likely are you to recommend us to a friend or colleague? 0 1 2 3 4 5 6 7 8 9 10 0 - Not at all 10 - Extremely likely If you are human, leave this field blank. Next Δ
