Email Test

What was the nature of your contact with us?

Please explain.

Which ABC office did you contact?

Select an office

Staff was courteous and helpful.

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Staff provided complete, accurate information to you.

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A timely response was provided.

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My overall experience was positive.

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Did your contact with us involve permitting/licensing/registration assistance?

Yes

No

The regulations were understandable.

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The application instructions were understandable.

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The permit/license/registration terms and conditions were understandable.

Select the most appropriate option

Please indicate the name(s) of any staff person you would like to commend.

Comments

If you feel we fell short in meeting your service expectations, including bilingual services, please describe the situation, including name of the staff person involved and the date the incident occurred.

As a result of your experience with us, what service-related improvements can you recommend?

Would you like us to contact you?

Yes

No

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Your Name *

Daytime Phone

Address

City

State

Zip Code

Your Contact Information

Licensee Information

Complaint Information

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