CUSTOMER SERVICE FEEDBACK FORM

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CUSTOMER SERVICE FEEDBACK FORM - Haldimand County

CUSTOMER SERVICE

FEEDBACK FORM

Haldimand County is committed to providing high quality customer service.

We value all of our customers and it is our goal to make sure that we meet

reasonable expectations and make improvements where necessary.

This document is available in alternative formats upon request.

Please submit your completed form to any of the following:

E-mail to: customerfeedback@haldimandcounty.on.ca

Fax to: 905-774-4294 or 905-772-3542

Mail or deliver to:

or

Haldimand County Cayuga Administration Building

45 Munsee Street North, Cayuga ON N0A 1E0

Haldimand County Haldimand County Haldimand County

Dunnville Satellite Office Hagersville Satellite Office Caledonia Satellite Office

111 Broad Street East 1 Main Street South 282 Argyle Street South

Dunnville, ON N1A 2X4 Hagersville, ON N0A 1H0 Caledonia, ON N3W 1K7

1. Please tell us the date, time and location of your contact with us.

_________________________________________________

_________________________________________________

2. Did we respond in a satisfactory way to your customer needs?

Yes ___

No ___

If not, please explain:

________________________________________________

3. Did you encounter any problems in accessing our goods and services?

Yes ___

No ___


4. Please provide the details of your customer service experience.

Do you wish to receive a reply from staff? Yes ___ No___

Preferred Method of Contact: Phone E-Mail

Contact Information:

Name:

Address:

Phone:

E-mail:

_______________________

_______________________

_______________________

_______________________

_______________________

Personal information contained on this form is collected by the Corporation

of Haldimand County or the Haldimand County Public Library Board under

the Municipal Freedom of Information and Protection of Privacy Act R.S.O.

1990, c.M.56. Questions about the collection of this information can be

addressed to Haldimand County’s Municipal Freedom of Information

Coordinator at 905-318-5932, ext. 262.

Thank you for helping us to improve our services.

For Haldimand County use only

Request No. Received by

(name)

Comments

Referred to

(name)

Date referred

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