FOLLOW-UP EVALUATION

Please take a few moments to complete this evaluation form, as your honest feedback will assist the staff of CCRS in more effectively meeting your needs and those of your organization. Thank you for your time in completing the evaluation.

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Question 1:

Please rate your overall experience with CCRS on a scale of 1 – 5 (1 poor 5 excellent)

1	2	3	4	5
Poor	Satisfactory			Excellent

Additional Comments:


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Question 2:

What mode of contact did you use to reach us? (Please check all that apply)

Hotline
Website
Main Number
Library Appt.
Walk In
Other:

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Question 3:

How did you learn of our Services?

CSB Newsletter
Referral from:
Other:
Good Cause AD
Word of Mouth

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Question 4:

How long did it take for you to obtain the information you requested?

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Question 5:

Do you feel better informed after your communication with CCRS staff members? Were your questions effectively answered?

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Question 6:

Are there additional materials/services or resources on this topic that we should add to our collection?

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Question 7:

Please use this space to let us know about your progress on the project or activity you were working on when you called us.

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Question 8:

Do you have any comments and/or suggestions?

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Optional Contact Information:

Name:
Current Address:
Email:
Phone:

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