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2. Department Satisfaction Survey
   Have you had an interaction with a county department and/or program you want to tell us about? Use this form to let us know how satisfactory you found that interaction.
4. Department Name
   -- Select One --AgricultureAssessorAuditor-ControllerAviation Board of Supervisors Child Support ServicesClerk-Recorder Registrar of VotersCooperative ExtensionCounty Administrative OfficeCounty Counsel Department of Health & Human ServicesDistrict AttorneyHuman ResourcesLibraryPlanning & BuildingProbationPublic DefenderPublic WorksSheriffTreasurer-Tax Collector
5. Division
   -- Select One --AdministrationAdult Protective ServicesBehavioral Health - Adult ServicesBehavioral Health - Children ServicesBehavioral Health - SempervirensBehavioral Health -Substance Use Disorder (SUD)Environmental HealthHousing, Outreach, Mobile Engagement (HOME)In Home Supportive Services (IHSS)Public AuthorityPublic GuardianPublic Health Social Services - Child Welfare Services (CWS)Social Services - Eligibility Veteran Services
6. Division
   -- Select One --Rex Bohn - 1st DistrictMichelle Bushnell - 2nd DistrictMike Wilson - 3rd DistrictVirginia Bass - 4th DistrictSteve Madrone - 5th DistrictClerk of the Board
8. Division
   -- Select One --Clerk RecorderElections - Registrar of Voters
9. Division
   -- Select One --ADA ComplianceCommunicationsEconomic DevelopmentInformation Technology Management - BudgetPurchasing
10. Division
    -- Select One --Revenue RecoveryTax CollectionTreasury
12. Division
    -- Select One --Facilities Maintenance Fleet ServicesLand UseNatural ResourcesParks - TrailsRoadsSolid WasteTransportationWater Management
13. Division
    -- Select One --Arcata Blue Lake BookmobileEureka FerndaleFortunaGarbervilleHoopaMcKinleyvilleTrinidad Rio DellWillow Creek
14. Division
    -- Select One --Advance PlanningBuilding InspectionCannabis PlanningCurrent PlanningCode Enforcement
16. Division
    -- Select One --Animal ControlCoronerCorrectional ServicesCourt ServicesCriminal InvestigationsDispatchOffice of Emergency Services
17. Division
    -- Select One --Adult ServicesJuvenile Services
19. Use the link below to leave feedback for the Sheriff-Coroner's Office
    Complaints and Commendations Forms
21. Use the link below to leave feedback for the Aviation Department
    Aviation Work Order Form
23. Use the link below to connect with a Librarian
    Connect with a Librarian Form
25. Use the link below to leave feedback for the Assessor's Office
    Assessor Customer Service Form
27. Use the link below to leave feedback for Child Support Services
    Child Support Customer Satisfaction Survey

    PLEASE NOTE: THIS IS NOT CHILD WELFARE SERVICES
29. Date of Interaction
    Date of Interaction
30. Was the interaction
    -- Select One --In PersonOver PhoneVia Email
32. 1. How satisfied were you with the service you received?

    1. Very Satisfied
    2. Satisfied
    3. Dissatisfied
    4. Very Dissatisfied
34. 2. County staff gave me complete and consistent answers:

    1. Strongly Agree
    2. Agree
    3. Disagree
    4. Strongly Disagree
36. 3. How friendly were the employees?

    1. Very Satisfied
    2. Satisfied
    3. Dissatisfied
    4. Very Dissatisfied
38. 4. County staff was knowledgeable in their area of responsibility and professional:

    1. Strongly Agree
    2. Agree
    3. Disagree
    4. Strongly Disagree
40. 5. County staff responded to me in a timely manner by email/phone (Typically within 24-48 Hours)

    1. Strongly Agree
    2. Agree
    3. Disagree
    4. Strongly Disagree
42. 6. Comments/Suggestions for the Department:
44. 7. Would you like someone from our office to contact you regarding the service you received?

    1. Yes
    2. No
46. 8. Contact Information (Optional)
48. Your Name (First/Last)
49. Phone Number
51. Email Address
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field