Client Satisfaction Survey Form

Client Satisfaction Survey

Please, read and respond accordingly to every question asked below
Name*

First NameLast Name
What program do you attend?*
How did you know about our agency?
How likely would you recommend LRII?

Please, let us know about your experience with the receptionist you spoke with most recently. Please indicate whether you agree or disagree with the following statements

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
The employee was very courteous
The employee handled my call quickly
The receptionist was very knowledgeable

Please rate the following aspects of your experience with the services provided:

	Poor	Fair	Good	Very Good	Excellent
Knowledge of the service
Understanding of your needs
Willingness to help
Efficiency/Quickness
Courteousness
Offered pertinent guidance
Time to address questions
Level of satisfaction with the service

Of the following list of attributes, our employee possed? (Choose all that applies)

PatienceEnthusiasmKnowledgableFriendlinessResponsiveUnderstanding
Please, let us know how are we doing or improve our services?
As a service provider, we are committed to keep your privacy and confidentiality at the forefront of our service. Therefore, we would like to ask if we can use your comments to keep on promoting our services and agency in our website and social media; certainly, without exposing your identity.

YESNO
Should be Empty: