Customer Feedback Form

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Please correct the field(s) marked in red below:

The City of Rock Hill strives to provide you with quality service. Help us to evaluate our service by giving us your opinion of your recent contact with us.
1
Date of Service/Contact
2
Department/Division that served you:
3
Name of employee(s) who served you (if known):
4
Please rate the following questions based on a 1 to 5 scale (1 = unsatisfactory and 5 = high satisfaction)
Please rate the following questions based on a 1 to 5 scale (1 = unsatisfactory and 5 = high satisfaction)
1 2 3 4 5
Did we listen attentively to your concern/problem?
How satisfied were you with suggestions offered?
How prompt was our response?
Were you treated courteously?
Did our employee act in a professional and business-like manner?
5
Please describe the nature of the service/contact:
6
If you would like a personal follow-up to your concerns, please provide your contact information:
If you would like a personal follow-up to your concerns, please provide your contact information:
  1. To receive a copy of your submission, please fill out your email address below and submit.