Charlotte Water Customer Feedback
Survey

Question Title

* 1. What method of contact describes your interaction
with Charlotte Water?

Phone

In-Person

Letter/Door Hanger

Web Portal

Other (please specify)

Question Title

* 2. Date of Service

Type or Select Calendar

Date

Question Title

* 3. What service did you receive? Choose from the List.

Water Turn-on

Water Turn-off

Meter Reading

High Bill Inspection

Water Line Repair

Water Quality

Water Meter Pressure/Flow Test Inspection

Equipment Replacement

Water and/or Sewer Installation

Sanitary Sewer Backup/Repair

Pre-Billing Quality Assurance Inspection

Other (please specify)

Question Title

* 4. How satisﬁed were you with the service that yo
received? Please select one option: 1 (very dissatisﬁed), 2 (Dissatisﬁed), 3 (neither satisﬁed or dissatisﬁed), 4 (satisﬁed) or 5 (very satisﬁed).

Question Title

* 5. Comments:

Question Title

* 6. Names of Charlotte Water staff members(s) who assisted you:

Question Title

* 7. Contact Information (optional)

Name:

Address:

Email:

Phone:

Charlotte Water Customer FeedbackSurvey

Question Title

* 1. What method of contact describes your interactionwith Charlotte Water?

Question Title

* 2. Date of Service

Question Title

* 3. What service did you receive? Choose from the List.

Question Title

* 4. How satisﬁed were you with the service that yoreceived? Please select one option: 1 (very dissatisﬁed), 2 (Dissatisﬁed), 3 (neither satisﬁed or dissatisﬁed), 4 (satisﬁed) or 5 (very satisﬁed).

Question Title

* 5. Comments:

Question Title

* 6. Names of Charlotte Water staff members(s) who assisted you:

Question Title

* 7. Contact Information (optional)

Charlotte Water Customer Feedback
Survey

* 1. What method of contact describes your interaction
with Charlotte Water?

* 4. How satisﬁed were you with the service that yo
received? Please select one option: 1 (very dissatisﬁed), 2 (Dissatisﬁed), 3 (neither satisﬁed or dissatisﬁed), 4 (satisﬁed) or 5 (very satisﬁed).