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Quality Service Survey for Child Care Services

  1. How did you hear about us?

  2. 1. How did you contact us?

  3. 2. Do you feel that you were waited on promptly?


  4. 6. Were your questions answered to your satisfaction?


  5. 7. Did the staff person explain and review your forms with you?


  6. 8. Did you get the information you needed to help you choose a provider?


  7. 9. Do you feel that the staff person acted in your best interest?


  8. 10. Do you feel that the staff person is well supervised and well trained?

  9. Knowledgeable

  10. Competent

  11. Patient

  12. Enthusiastic

  13. Listens carefully

  14. Friendly

  15. Responsive

  16. Courteous

  17. Leave This Blank:

  18. This field is not part of the form submission.