Customer Feedback Form

 

Have something you would like to tell us?  Please use this form for whatever you have to say - maybe someone you'd like to thank, a request for additional information or a problem you encountered?   What ever it is, we're listening!   Let us know if you want us to contact you and the best way to do that. 

Your contact information will be kept confidential and will only be used for this specific purpose.  You'll be hearing from us soon.

 

1

What would you like to say?

 *

What would you like to say?

2

If your feedback is about City Staff, please let us know the name or department

If your feedback is about City Staff, please let us know the name or department

3

If your feedback is about City Staff, how would you rate your overall experience?

If your feedback is about City Staff, how would you rate your overall experience?

Horrible If other, type text here.

Acceptable If other, type text here.

Above Average If other, type text here.

Excellent If other, type text here.

4

Any other comments?

Any other comments?

5

Would you like us to contact you?

Would you like us to contact you?

6

How would you like us to contact you?

How would you like us to contact you?

Email

Phone

Mail

Other

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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