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* 1. How would you rate your satisfaction with the information or
services you received?

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* 2. I got the information or service that I needed. (Accessibility)

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* 3. The service or information was clear and understandable. (Clarity)

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* 4. The staff was friendly and polite. (Courtesy)

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* 5. The staff was well informed. (Knowledge)

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* 6. The staff was helpful. (Helpfulness)

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* 7. I was served in a timely manner. (Timeliness)

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* 8. Location

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* 9. Program

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* 10. What was the date of service?

Date

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* 11. Additional Comments

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* 12. Do you wish to be contacted regarding your visit? (YOU WILL BE CONTACTED WITHIN 5 BUSINESS DAYS)

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