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* 1. For the purpose of this survey, how you would define yourself? 

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* 2. What section are you giving feedback on?

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* 3. How satisfied are you with HFSC services?

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* 4. This space can be used for all feedback. If your feedback is case specific, please include all relevant information, including agency case number and your contact information so we can directly address your feedback. 

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* 5. If you would like to be contacted regarding your feedback, please include your contact information

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