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Greensboro Office Visit Survey
   
1.  Please provide the date of your visit.
    mm/dd/yy
   
2.  What was the purpose of your visit?
  Schedule an appointment
Inquire about services
Inquire about the status of my case
Pick up / Drop off documents
Other (specify)
  
   
3.  I was greeted in a courteous and polite manner.
   
4.  I received prompt service.
 
   
5.
 The person/people I spoke with seemed knowledgeable and were able to answer
my questions and/or resolve my concerns.
 
 
6.
 The appropriate actions will be taken on my case.   
 
   
 
7.
 Overall, the quality of service I received during my visit was:
 
Excellent
Good
Fair
Poor
 
8.
 Who did you speak to during your visit?
  Receptionist
Agent
Receptionist and Agent
Other (specify)
  
   
9.  May we contact you in regard to this?
  Yes No
   
   If so please provide your name and daytime phone number.
   Name:  Phone Number:
   
  Comments and Suggestions:
 
   
 
   
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