Form 5800-003 Customer Service Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)

Customer Service Survey

EPA Docket Center Customer Satisfaction Survey

OMB: 2030-0051

Document [docx]
Download: docx | pdf

OMB Control No.: 2010-0042

Expires: 3/31/2021

Form #: 5800-003

U.S. EPA Docket Center

(staffed by ASRC Management Services)

CUSTOMER SERVICE SURVEY



Dear Patron,


Thank you for completing this short survey. Your response will help improve the customer experience at the U.S. EPA Docket Center.


QUESTIONS

  1. How was your request submitted?

Reply format: radio buttons (pick one).

  • Email

  • Phone

  • Walk-in

  • Other


  1. Are you an EPA employee/contractor OR a member of the public?

Reply format: radio buttons (pick one)

  • EPA employee/contractor

  • A member of the public


  1. Did the staff provide the information or document/s you requested?

Reply format: radio buttons (pick one)

  • Yes

  • No


  1. Did the staff provide recommendations/referrals, if needed?

Reply format: radio buttons (pick one)

  • Yes

  • No

  • Not Applicable


  1. Was the service or information provided in timely manner?

Reply format: radio buttons (pick one)

  • Yes

  • No


  1. How friendly and courteous was your encounter with the EPA Docket Center staff?

Reply format: Slider from 1-5. 1 being Poor and 5 being Excellent


  1. How would you rate the overall service provided by the EPA Docket Center Customer Service?

Reply format: Slider from 1-5. 1 being Poor and 5 being Excellent

  1. Suggestions/Additional Comments:

Reply format: Free text box


Thank you for your valuable input.



The public reporting and recordkeeping burden for this collection of information is estimated to average 5 minutes per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, included through the use of automated collection techniques to the Director, Regulatory Support Division, U.S. Environmental Protection Agency (2821t), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed survey to this address.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleUS EPA Docket Center
AuthorLCAROTHE
File Modified0000-00-00
File Created2021-12-05

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