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Customer Comment Card

2. Name

3. Email Address

5. Address

7. City

8. State

9. Zip Code

11. Phone Number

15. Service Date/Time
    Service Date/Time

    Service Date/Time

17. Does this comment apply to a particular Town employee

    1. Yes
    2. No

19. Describe Services Provided

    Provide the name or a description of the area of service on which you are commenting.

23. About Exceptional Service

    Tell us about the outstanding customer service you received at the Town of Bluffton.

25. About Improving Services

    Tell us what activity, process or service you think could be improved at the Town of Bluffton. Please provide examples of how you think it could be improved.

29. Please rate our Courteous Attitude

    1. Poor
    2. Fair
    3. Good
    4. Excellent

30. Please rate our Responsiveness

    1. Poor
    2. Fair
    3. Good
    4. Excellent

32. Please rate our Employee's Knowledge

    1. Poor
    2. Fair
    3. Good
    4. Excellent

33. Please Rate our Overall Service

    1. Poor
    2. Fair
    3. Good
    4. Excellent

Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field