CUSTOMER SERVICE FEEDBACK FORM

CUSTOMER SERVICE
FEEDBACK FORM
Haldimand County is committed to providing high quality customer service.
We value all of our customers and it is our goal to make sure that we meet
reasonable expectations and make improvements where necessary.
This document is available in alternative formats upon request.
Please submit your completed form to any of the following:
E-mail to: customerfeedback@haldimandcounty.on.ca
Fax to: 905-774-4294 or 905-772-3542
Mail or deliver to:
or
Haldimand County Cayuga Administration Building
45 Munsee Street North, Cayuga ON N0A 1E0
Haldimand County Haldimand County Haldimand County
Dunnville Satellite Office Hagersville Satellite Office Caledonia Satellite Office
111 Broad Street East 1 Main Street South 282 Argyle Street South
Dunnville, ON N1A 2X4 Hagersville, ON N0A 1H0 Caledonia, ON N3W 1K7
1. Please tell us the date, time and location of your contact with us.
_________________________________________________
_________________________________________________
2. Did we respond in a satisfactory way to your customer needs?
Yes ___
No ___
If not, please explain:
________________________________________________
3. Did you encounter any problems in accessing our goods and services?
Yes ___
No ___

4. Please provide the details of your customer service experience.
Do you wish to receive a reply from staff? Yes ___ No___
Preferred Method of Contact: Phone E-Mail
Contact Information:
Name:
Address:
Phone:
E-mail:
_______________________
_______________________
_______________________
_______________________
_______________________
Personal information contained on this form is collected by the Corporation
of Haldimand County or the Haldimand County Public Library Board under
the Municipal Freedom of Information and Protection of Privacy Act R.S.O.
1990, c.M.56. Questions about the collection of this information can be
addressed to Haldimand County’s Municipal Freedom of Information
Coordinator at 905-318-5932, ext. 262.
Thank you for helping us to improve our services.
For Haldimand County use only
Request No. Received by
(name)
Comments
Referred to
(name)
Date referred