Customer Satisfaction Form

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Customer Satisfcation Feedback Form

In each case, please indicate your satisfaction by ticking one of the standards of service that you feel you have received

How satisfied were you with the helpfulness of the housing staff	Poor	Fair	Good	Excellent
Were you dealt with courteously and with respect?	Poor	Fair	Good	Excellent
How efficient and quick have we been whilst dealing with you?	Poor	Fair	Good	Excellent
Were you able to see a Housing Officer at a time/date convenient to you?	Poor	Fair	Good	Excellent
Do you think that our forms and information leaflets are clear and easy to understand?	Poor	Fair	Good	Excellent
If you have special customer service requirements, i.e. you require a service that caters for disabled people or you needed help with translation, how well were these requirements met?	Poor	Fair	Good	Excellent

Do you have any other comments you wish to make?

Diversity Monitoring

Please answer the following questions to help us meet the changing needs of our customers. (Please tick the most applicable.)

Are you? Male Female

How would you best describe your background?

White

White - British	White - Irish	White - Portuguese
White - Easten European	White - Other

Mixed

Mixed & Black Caribbean	White & Black African	White & Black Asian
Any other mixed

Asian or Asian British

Indian	Pakistani	Bangladeshi
Asian other

Black or Black British

Caribbean	African	Black other

Other Ethnic Groups

Chinese	Koren	Other

Name & Address (optional):

If you would like a Manager to contact you about the service you have received, please give details here:

Contact details

Bournemouth Council
	Town Hall, Bourne Avenue Bournemouth BH2 6DY (Map )
	Tel: 01202 451451
	Fax: 01202 451000
	Minicom: 01202 454728
	Email: Enquiries

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This page is maintained by Housing and Voluntary Services Email Page Updated: 13 May 2008