On-the-Spot Feedback Survey Form
Please share your immediate feedback to help us improve your experience.
Overall, how satisfied are you with your experience?
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1
2
3
4
5
How likely are you to recommend us to others?
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Not likely at all
0
1
2
3
4
5
6
7
8
9
Extremely likely
10
0 is Not likely at all, 10 is Extremely likely
How did you interact with us today?
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In person
Online
By phone
Other
Please rate the friendliness of our staff.
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1
2
3
4
5
Please rate the speed of service.
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1
2
3
4
5
How easy was it to find what you needed?
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Very easy
Somewhat easy
Neutral
Somewhat difficult
Very difficult
What did you like most about your experience?
What could we improve?
Was your issue or request resolved today?
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Yes
No
Not applicable
Any additional comments or feedback?
Submit Feedback
Should be Empty: