Customer Service Satisfactory Survey

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* 1. Name of the person who helped you?

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* 2. Location of Service?

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* 3. How was your service conducted? (please select one from the dropdown).

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* 4. What services were provided? (Select all that apply)

SNAP

POC/Childcare

Medicaid

General Assistance

TANF

Hotel/Motel/Shelter Voucher

Utility Assistance

Other (please specify)

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* 5. Overall satisfaction (scale 1-5, with 5 being completely satisfied).

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* 6. On a scale of 1-5, were your needs met? (1 being not at all and 5 being all needs were met).

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* 7. Additional comments or suggestions

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* 8. Due to the survey being anonymous, there is no direct follow-up. Therefore, if you would like to talk to someone about your concerns, please call one of the customer service lines below.

DSS Customer Relations Unit 302-571-4900

Constituent Relation 302-223-1568 or dhssinfo@delaware.gov