Client Survey

Community Credit Counseling Specialists
"Your COMMUNITY Credit Counseling Service."
A Non-Profit Community Service
Helping Consumers Become Debt-Free Since 1982

Client Survey
Help us improve our service.

We Are ISO 9000 Quality Certified
ISO 9000:2008
FS59499

INSURED
AND
BONDED

Client Satisfaction Survey

This survey is for clients who have either recently contacted us or received financial counseling from our agency.

This is a self monitoring survey that is used to insure that:

Our agency is providing the information and/or financial counseling needed by our clients,
That it is both useful and easily understood, and
That it was presented in a professional and courteous manner.

This is a confidential survey. Any information obtained in this survey will only be used by and within our agency. We ask that you include your name and address on this form only to insure that we can properly identify your file in our system.

Thank you, the CCCS staff.

	Confidential Client Satisfaction Survey Form

First and Last Name:*
Spouse Name:
Email:
Address:*
City:*
State:*
Zip:*

1.)		When you first contacted our agency for an appointment, were you treated in a courteous and professional manner? Yes \| No
Additional Comments:

2.)		If you have completed an appointment, were you treated in a courteous and professional manner during your appointment by our office staff, either in person or by telephone? Yes \| No \| N/A
Additional Comments:

3.)		If you have completed an appointment, were several possible solutions for improving your finances presented to you in an Action Plan? Yes \| No
Additional Comments:

4.)		How would you rate your overall experience when you contacted our agency? Excellent \| Very good \| Good \| Fair \| Poor
Additional Comments:

* Required fields