IAC Customer Satisfaction Survey

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IAC CUSTOMER SATISFACTION SURVEY
FORM APPROVED OMB NO. 1040-0001
  Expires: 06/30/2015

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Overall Service Rating

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*1. How would you rate your overall satisfaction with the products/services you have received?
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Very Satisfied

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Satisfied

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Neutral

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Dissatisfied

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Very Dissatisfied

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Use of Products & Services

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*2. How long have you used our products/services?
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Less than 6 months

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6 months to 1 year

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1 year to less than 3 years

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3 years to less than 5 years

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5 years or more

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*3. Which of our products/services do you use? (Check all that apply)
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Map purchase

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Copy services

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Certified document services

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Notary services

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Onsite research/case file review

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Filing of leases, applications or claims

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Permit or pass purchase

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*4. How frequently do you use our services?
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Daily

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Weekly

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Monthly

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Every 2 ‐ 3 months

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Every 6 months

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Annually

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*5. What was the purpose of your visit today? Please check all that apply.
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Map purchase

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Copy services

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Certified document services

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Notary services

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Onsite research/case files

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Oil & Gas/Geothermal

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Mining

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Quality of Products & Services

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*6. Thinking of similar products/services offered by other organizations, how would you compare the
products/services offered by our organization?

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Much better

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Somewhat better

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About the same

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Somewhat worse

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Much worse

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Don’t know

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*7. Please rate our staff on the following attributes:
Very Good

Good

Fair

Poor

Very Poor

Accuracy

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Courtesy

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Efficiency

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Professionalism

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Responsiveness

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Timeliness

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8. Do you have any suggestions on how we could improve our products or services or additional products or
services we could provide to improve your customer experience?
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Customer Demographics

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9. Please indicate your age:
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Under 18 years

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18 ‐ 24 years

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25 ‐ 34 years

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35 ‐ 44 years

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45 ‐ 54 years

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55 ‐ 64 years

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65 years or above

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10. Please indicate your gender:
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Male

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Female

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If you would like to discuss your responses or have additional recommendations to provide, please contact Dilene A. Smith, Chief, Branch
of Information Access & Customer Service.
Thank you for taking the time to complete our survey. Your opinion is extremely valuable to us.
Paperwork Reduction Act
The purpose of this survey is to provide information to the Bureau of Land Management for evaluating and improving the recreation
services and programs that it provides to the public. Response to this survey is voluntary. No action may be taken against you for

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refusing to supply the information requested. The reporting burden for this form is estimated to average 3 minutes, which includes the
time for reviewing instructions and completing and reviewing the form. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid Office of Management and Budget (OMB) control
number. Please direct comments regarding the burden estimate or any other aspect of this form to: U.S. Department of the Interior,
Bureau of Land Management (1040-0001), Bureau Information Collection Clearance Officer (WO-630), 1849 C Street, N.W., Room
2134LM, Washington, D.C. 20240.
Privacy Act Statement
No Privacy Act Information is being collected; therefore, no direct link to the individual(s) filling out this survey will be available.
Information collected will be compiled to produce statistics.

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