Local Government Services Feedback Questionnaire
Share your experience and help us improve local government services in your community.
Which area or neighborhood do you reside in?
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What is your age group?
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55-64
65 or older
Which of the following local government services have you used in the past 12 months? (Select all that apply)
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Waste collection and recycling
Public parks and recreation
Road maintenance
Water and sanitation
Public transportation
Community health services
Permitting and licensing
Public safety (police, fire, emergency)
Other
How would you rate the overall quality of local government services?
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1
2
3
4
5
Please rate the following aspects of local government services:
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Rows
Very Poor
Poor
Average
Good
Excellent
Timeliness of service delivery
1
2
3
4
5
Staff professionalism
6
7
8
9
10
Ease of access to services
11
12
13
14
15
Clarity of information provided
16
17
18
19
20
Responsiveness to inquiries
21
22
23
24
25
How easy was it to access the services you needed?
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Very difficult
Difficult
Neutral
Easy
Very easy
Have you experienced any issues or problems with local government services?
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Yes
No
If yes, please describe the issue(s) you experienced.
What suggestions do you have for improving local government services?
Would you like to be contacted for follow-up regarding your feedback?
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Yes, please contact me
No, I prefer to remain anonymous
If yes, please provide your email address.
example@example.com
Please verify that you are not a robot.
*
Submit Feedback
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