Thank you for the opportunity of referring consumers to our organization recently. Please take a few moments to rate the following so that we may continue to improve our services. All surveys are confidential.

    Follow up contact will be made within one week of you receiving this survey, if we have not received a response from you.

    CHECK ONLY ONE ANSWER Excellent Good Average Poor N/A
    1. Staff returned my call within 24 hours? ExcellentGoodAveragePoorN/A
    2. Staff was courteous, professional and helpful? ExcellentGoodAveragePoorN/A
    3. Availability of staff ExcellentGoodAveragePoorN/A
    4. Turn around time from phone call to appointment ExcellentGoodAveragePoorN/A
    5. Response time of disposition of consumer ExcellentGoodAveragePoorN/A
    6. Protection of consumer’s privacy/confidentiality ExcellentGoodAveragePoorN/A
    7. Possibility of future referrals to FWC ExcellentGoodAveragePoorN/A
    8. Possibility of recommending us to another agency ExcellentGoodAveragePoorN/A
    9. How would you rate our quality of service? ExcellentGoodAveragePoorN/A
    10. In an overall, general sense, how would you rate your experience with the referral process? ExcellentGoodAveragePoorN/A