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Customer Satisfaction Survey

Thank you for giving us the opportunity to serve you better!

Please help us by taking a few minutes to tell us about the quality of the service that you have received recently. We appreciate your feedback and want to make sure we meet your needs.
This question requires a valid date format of MM/DD/YYYY.
calendar
This question requires a valid number format.
3. What was the *Main* service / information that you received from us?
4. How did you connect with us on this date?
5. How easy was it to find what you were looking for on our website?
 012345678910 
Very DifficultVery Easy
5. Please rate us on the following:
Space Cell Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeN/A
I was treated with courtesy and respect by the staff who helped me today
Staff were professional, knowledgeable, and competent
Services and information were received in a timely and efficient manner
Overall I am pleased with my experience today
6. Do you wish to be contacted about your recent experience?
This question requires a valid email address.
A TLCHD staff member will reach out to you soon, thank you for allowing us to serve you better.
7. How did you find out about our services?
9. What language(s) do you speak at home?
10. Gender:
11. Age:
12. Race:
13. Are you of Hispanic, Latino/a, or Spanish origin?
14. Are you of Arab ancestry/ethnic origin?
(Arab, Egyptian, Iraqi, Jordanian, Lebanese, Middle Eastern, Moroccan, North African, Palestinian, Syrian)