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2. Please enter the date of service you are completing this survey for:
   Please enter the date of service you are completing this survey for:
4. Customer Service Rating
   Please check the City Department(s) with which you interacted and rate the customer service level for each:
6. City Departments

   1. Building Inspection
   2. City Council Office
   3. Community Center
   4. Community Revitalization
   5. City Income Tax
   6. City Manager's Office
   7. Engineering
   8. Environmental Services

   1. Economic Development
   2. Fire
   3. Health
   4. Municipal Court
   5. Ohio Small Business Office
   6. Personnel
   7. Planning / Community Development
   8. Police

   1. Parks / Street Maintenance
   2. Transit (Bus)
   3. Water Services (Billing)
   4. Water / Sewer Maintenance
   5. Water Treatment Plant
   6. Waste Water Treatment
   7. Weatherwax Golf Course
8. Building Inspection

   1. Poor

   1. Good

   1. Excellent
10. City Council Office

    1. Poor

    1. Good

    1. Excellent
12. Community Center

    1. Poor

    1. Good

    1. Excellent
14. Community Revitalization

    1. Poor

    1. Good

    1. Excellent
16. City Income Tax

    1. Poor

    1. Good

    1. Excellent
18. City Manager's Office

    1. Poor

    1. Good

    1. Excellent
20. Engineering

    1. Poor

    1. Good

    1. Excellent
22. Environmental Services

    1. Poor

    1. Good

    1. Excellent
24. Economic Development

    1. Poor

    1. Good

    1. Excellent
26. Fire

    1. Poor

    1. Good

    1. Excellent
28. Health

    1. Poor

    1. Good

    1. Excellent
30. Municipal Court

    1. Poor

    1. Good

    1. Excellent
32. Ohio Small Business Office

    1. Poor

    1. Good

    1. Excellent
34. Personnel

    1. Poor

    1. Good

    1. Excellent
36. Planning / Community Development

    1. Poor

    1. Good

    1. Excellent
38. Police

    1. Poor

    1. Good

    1. Excellent
40. Parks / Street Maintenance

    1. Poor

    1. Good

    1. Excellent
42. Transit (Bus)

    1. Poor

    1. Good

    1. Excellent
44. Water Services (Billing)

    1. Poor

    1. Good

    1. Excellent
46. Water / Sewer Maintenance

    1. Poor

    1. Good

    1. Excellent
48. Water Treatment Plant

    1. Poor

    1. Good

    1. Excellent
50. Waste Water Treatment

    1. Poor

    1. Good

    1. Excellent
52. Weatherwax Golf Course

    1. Poor

    1. Good

    1. Excellent
54. Were you greeted upon arrival?

    1. Yes

    1. No
56. If your contact was via telephone, were you transferred to another department?

    1. Yes
    2. No
58. If yes, how many times?
60. What improvements could we make for your interaction to be easier and more productive?
62. Your Name/Company Name/Phone/Address/Email Address: (Please note, anonymous surveys may be invalidated)
64. Would you like to be contacted so that you can provide additional feedback?

    1. Yes

    1. No
Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit

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