| Please provide feedback on the services the Environmental Assistance Program (EAP) recently provided you. |
| 1. Why did you contact us? |
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| 2. Who from the EAP assisted you? (check all that apply) |
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| 3. Did our staff respond in a timely manner? |
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| 4. How would you describe the professionalism and courteousness of our staff? |
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| 5. Did our staff answer your questions appropriately? |
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| 6. What change(s) occurred as a result of our staff assistance? (check all that apply) |
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| 7. Do you have specific suggestions on how we can improve our services? |
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| 8. Would you recommend our services to others? |
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| OPTIONAL |
| Name, phone, email |
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