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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