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2. Department Contacted
3. Date of Contact
5. Type of Contact
   -- Select One --Met With StaffTelephoneWrittenFaxPublic MeetingOther (Please Specify)
6. Other Type of Contact
8. Name of Staff Member Contacted
10. Nature of Your Contact
    -- Select One --Information OnlyService RequestPermit / LicenseOther (Please Specify)
11. Other Nature of Your Contact
13. How would you rate the services you recieved?

    1. Excellent
    2. Above Average
    3. Average
    4. Below Average
    5. Unsatisfactory
15. How could we improve the service you received?
17. If you would like someone to contact you, please let us know the most convenient method and time to contact you.
19. Name
20. Phone Number
22. Email Address
23. Best Time to Contact
25. Comments
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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