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2. The Housing Authority is dedicated to continuously seeking ways to way to improve its service. Please assist us by taking a moment to fill out this brief survey to help us evaluate our efforts. Your comments and concerns are important to us, and we are grateful for your input.
4. Please describe the nature of your contact with HACC:
   -- Select One --Email ContactMail ContactPersonal Visit to the HACC OfficePhone Contact
6. Please indicate which program your contact with HACC concerned:
   -- Select One --Emergency Home RepairFamily Self Sufficiency (FSS)Home RehabHOPWALead Hazard ControlSection 8
8. Please choose the option that best describes the purpose of this contact with HACC:
   -- Select One --Addressing a problem or concernAnnual recertificationApplying to participate in a programNoneReporting a change of income or family composition Seeking general information about a program
10. Please rate these areas of service:
12. Promptness with which you were assisted.

    1. Very Poor
    2. Poor
    3. Fair
    4. Good
    5. Excellent
13. Staff was knowledgeable of programs and requirements.

    1. Very Poor
    2. Poor
    3. Fair
    4. Good
    5. Excellent
15. Information provided was easily understood and accurate.

    1. Very Poor
    2. Poor
    3. Fair
    4. Good
    5. Excellent
16. Staff was professional, courteous and friendly.

    1. Very Poor
    2. Poor
    3. Fair
    4. Good
    5. Excellent
18. Please rate your overall level of satisfaction with the services you recently received from this department:

    1. Very Satisfied
    2. Satisfied
    3. Neither Satisfied nor Dissatisfied
    4. Dissatisfied
    5. Very Dissatisfied
20. As a result of your visit/contact, what service-related improvements would you recommend?
22. If you would like to be contacted about your experience, or for any other reason, please provide your name and email.
24. Name
25. Email Address
Leave This Blank:


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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