Form FD-1000 FBI Laboratory Customer Satisfication Assessment

FD-1000 (03-06-06)OMB1110-0045

Exp. 09/03/2009

FBI Laboratory

Customer Satisfaction Assessment

Thank you for using the services of the FBI Laboratory. In an effort to improve our services to you and your

agency, please provide feedback on your experience in relation to this case. Upon completion of this survey,

please return it by fax to the Quality Assurance and Training Unit at 703-632-8285.

Name of Examiner: ______________________________ Unit: ____________________________________

Name of Request Coordinator (RC): ______________________________

Laboratory Number: ______________________________

Your Name: ____________________________________ Agency: __________________________________

Phone: ________________________________

Please rate the following for your experience with the FBI Laboratory:

[ 1 = Poor 2 = Fair 3 = Good 4 = Very Good 5 = Excellent N/A = Not Applicable]

A.Your contact with the Evidence Examiner:

12345N/A

B.Your contact with the Request Coordinator:

12345N/A

C.The timeliness of the completion of your examination request:

12345N/A

D.The clarity of the FBI Laboratory report:

12345N/A

E.The overall quality of service received:

12345N/A

Thank you for taking the time to help us improve our services.

Date Received in QATU __________________ by __________Entered in Assessment Database __________________Copy to ECU________

PAPERWORK REDUCTION ACT NOTICE

The information required on this form is in accordance with the Paper Reduction Act of 1995. The estimated average burden associated with this collection

of information is 5 minutes. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed

to Federal Bureau of Investigation, Laboratory Division, Quality Assurance and Training Unit, 2501 Investigative Parkway, Quantico, Virginia 22135.