Form VS 1-10 VS 1-10 Customer Service Survey

According 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 number for this information collection is 0579-0334. The time required to
complete this information collection is estimated to average .089 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

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) submit a scanned copy by email to [email protected] or (2) 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

Pet Animal Export

Farm Animal Import

Farm Animal Export Type of farm animal (Specify):

Animal Product Import

Animal Product Export

Organisms and Vectors

Type of pet (Specify):

Type of animal product (Specify):

Type of organism or vector (Specify):

Diagnostic Testing

National Veterinary Accreditation Program

Farm Animal Programs

Other (Specify):
WHICH VETERINARY SERVICES OFFICE DID YOU CONTACT:
Riverdale, MD

Fort Collins, CO

Raleigh, NC

Ames, IA

Port Office (Specify):

Federal Animal Quarantine Facility (Specify):
Area, Field, or Endorsement Office (Specify):
Other (Specify):
WHICH FORM OF CONTACT DID YOU USE:
Email

Phone

Fax

Direct (face-to-face)

2. IN THE PAST 12 MONTHS APPROXIATELY HOW MANY TIMES HAVE YOU CONTACTED VETERINARY SERVICES?
1-5

6-10

11-20

21+30

31 or More

3. 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

PROFESSIONALISM
Satisfied
HELPFULNESS
Satisfied
TIMELINESS
Satisfied
KNOWLEDGE
Satisfied
COMMUNICATION
Satisfied

TREATING YOU AS A VALUED CUSTOMER
Satisfied
VS Form 1-10
APR 2020

Somewhat Satisfied

4. HOW SATISFIED WERE YOU WITH YOUR OVERALL EXPERIENCE IN OUR OFFICE?
Satisfied

Somewhat Satisfied

5. WHAT WAS GOOD ABOUT OUR SERVICE?

6. WHAT COULD WE DO BETTER?

VS Form 1-10
APR 2020

Neither Satisfied nor Dissatisfied

Somewhat Dissatisfied

Dissatisfied

_____Fold here

TAPE HERE

PLACE STAMP
HERE

USDA, APHIS, VS, Strategy and Policy
Office of the Associate Deputy Administrator
4700 River Road, Unit 41
Riverdale, MD 20737

_____Fold here

VS Form 1-10
REVERSE
APR 2020