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Customer Satisfaction Survey
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County of Louisa Department of Fire & EMS
Customer Satisfaction Survey
How Was Our Service? By completing the following brief survey you can help us achieve our goal of providing excellent service to the County of Louisa.
Please identify your relationship with Louisa County Department of Fire and EMS.
Resident
Visitor
Business Owner / Manager
Employed within COunty Boundaries
Medical Patient
Fire or Rescue Victim
Class / Seminar Participant
Health Services Partner
Public Safety Partner
Government Agency Partner
Public Education Partner
Other
If Other, please specify.
Please indicate the reason(s) you had contact with the Louisa County Department of Fire and EMS.
Check all that apply.
Medical Response
Vehicle Accident
Rescue
Fire Response
Fire / Smoke/ Carbon Monoxide Alarm
Hazardous Material Response
Public Assist
Fire and Life Safety Education
If Other, please specify
Date
Date
Please provide the approximate date that you last received services from the Louisa County Department of Fire and EMS.
How would you rate the PROFESSIONALISM of our employees?
Exceeded my Expectations
Met my Expectations
Needs Improvement
Did Not Meet my Expectations
If you selected "Needs Improvement" or "Did Not Meet my Expectations"
Please tell us how we can improve.
How EFFECTIVE were our employees?
Exceeded my Expectations
Met my Expecations
Needs Improvement
Did Not Meet my Expectations
If you selected "Needs Improvement" or "Did Not Meet my Expectations"
Please tell us how we can improve.
Overall, how would you rate the QUALITY of the services you received from the Louisa County Department of Fire and EMS?
Exceeded my Expectations
Met my Expectations
Needs Improvement
Did Not Meet My Expectations
If you selected "Needs Improvement" or "Did Not Meet my Expectations"
Please tell us how we can improve.
Please share any final comments / suggestions.
Would you like someone from the Louisa County Department of Fire and EMS to contact you?
Yes
No
If you would like someone to contact you, please fill out the necessary information.
Name
Email
Phone Number
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Email address
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