Facilities Forms - Customer Survey Form – Housekeeping

NOTE: You may fill this form out anonymously.  Use the tab key or mouse to move from field to field.

Name:  
Department:  
Campus Address:  
Phone:  
E-mail:  
Please respond to the following statements about our service:

Responsiveness
When requested, you received prompt service or assistance.

Timeliness
Services are completed as scheduled.

Professionalism
Staff assistance is friendly and helpful.

Quality
Overall, you were satisfied with the service provided.

Value
Rate the overall value of the service received.


Excellent


Excellent


Excellent


Excellent


Excellent


Satisfactory


Satisfactory


Satisfactory


Satisfactory


Satisfactory

Needs
Improvement

Needs
Improvement

Needs
Improvement

Needs
Improvement

Needs
Improvement

Not
Applicable

Not
Applicable

Not
Applicable

Not
Applicable

Not
Applicable

  Is there anything we could do to improve our service?




 
 
 

Facilities Home KUSM-W Home

Last Modified: July 18, 2012
Copyright © 1998-2011, The University of Kansas School of Medicine-Wichita