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pdfAccording to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a valid OMB control number. The valid OMB control numbers for this information collection are 0579-0334 and 0579-0377. The
time required to complete this information collection is estimated to average .083 hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES
OMB APPROVED
0579-0334
CUSTOMER SERVICE SURVEY
AIC1
Your answers are voluntary, confidential, and anonymous and will be used by Veterinary Services to evaluate and improve customer service. This survey
can be completed/returned using any of the following methods: (1) online at https://www.surveymonkey.com/r/VSSurvey2016; (2) return this form to the
office you visited; (3) submit a scanned copy by email to [email protected]; or (4) fold this form and return it by mail using
the address on the reverse side.
1. IN WHAT CAPACITY DID YOU CONTACT VETERINARY SERVICES?
Pet Animal Import/Export
Farm Animal Import/Export
Product Import/Export
Accredited Veterinarian
Farm Animal Programs
Other (Specify)
Organisms and Vectors
2. HOW SATISFIED WERE YOU WITH VETERINARY SERVICES IN THE FOLLOWING CATEGORIES?
COURTESY
Satisfied
Somewhat Satisfied
Neither Satisfied nor Dissatisfied
Somewhat Dissatisfied
Dissatisfied
Somewhat Satisfied
Neither Satisfied nor Dissatisfied
Somewhat Dissatisfied
Dissatisfied
Somewhat Satisfied
Neither Satisfied nor Dissatisfied
Somewhat Dissatisfied
Dissatisfied
Somewhat Satisfied
Neither Satisfied nor Dissatisfied
Somewhat Dissatisfied
Dissatisfied
Somewhat Satisfied
Neither Satisfied nor Dissatisfied
Somewhat Dissatisfied
Dissatisfied
Somewhat Satisfied
Neither Satisfied nor Dissatisfied
Somewhat Dissatisfied
Dissatisfied
Neither Satisfied nor Dissatisfied
Somewhat Dissatisfied
Dissatisfied
Somewhat Dissatisfied
Dissatisfied
PROFESSIONALISM
Satisfied
HELPFULNESS
Satisfied
TIMELINESS
Satisfied
KNOWLEDGE
Satisfied
COMMUNICATION
Satisfied
TREATING YOU AS A VALUED CUSTOMER
Satisfied
Somewhat Satisfied
3. HOW SATISFIED WERE YOU WITH YOUR OVERALL EXPERIENCE IN OUR OFFICE?
Satisfied
Somewhat Satisfied
Neither Satisfied nor Dissatisfied
4. WHAT WAS GOOD ABOUT OUR SERVICE?
5. WHAT COULD WE DO BETTER?
IF YOU WOULD LIKE A RESPONSE FROM VETERINARY SERVICES, PLEASE PROVIDE YOUR NAME, PHONE NUMBER, AND/OR EMAIL.
NAME:
PHONE NUMBER:
VS Form 1-10
JUN 2016
EMAIL ADDRESS:
TAPE HERE
_____Fold here
PLACE STAMP
HERE
USDA, APHIS, VS, National Import Export Services
Office of the Associate Deputy Administrator
4700 River Road, Unit 41
Riverdale, MD 20737
_____Fold here
REVERSE
JUN 2016
File Type | application/pdf |
Author | smharris |
File Modified | 2017-04-26 |
File Created | 2016-06-14 |