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2. 1. What service(s) did we provide during your most recent interaction (check all that apply):

   1. Commercial Pre-Rinse Nozzles
   2. Commercial Water Broom
   3. Conservation Kit
   4. Conservation Visit at Your Property
   5. Help with Your Bill and/or Water Budget
   6. High-Efficiency Toilet Rebate
   7. HOA/Commercial Desert Landscaping Rebate
   8. HOA/Commercial Irrigation Upgrade Rebate
   9. HOA/Commercial Smart Irrigation Controller Rebate
   10. Information

   1. Plan Check Services
   2. Residential Desert Landscaping Rebate
   3. Residential High-Efficiency Washing Machine Rebate
   4. Residential Hot Water Recirculation Pump Rebate
   5. Residential Smart Irrigation Controller Installation or Follow-up
   6. Spray Nozzle Rebate
   7. Water Audit
   8. Water Waste Reporting or Citation
   9. Other
4. Other
6. 2. Who assisted you?
8. 3. How did you contact us for assistance ? (Check all that apply.)

   1. Email
   2. In Person

   1. Phone
   2. Website

   1. Other
10. Other
12. 4. How would you rate the courtesy and professionalism of our staff?
    -- Select One --ExcellentAbove averageAverageBelow averagePoorN/A
14. 5. How would you rate the timeliness of our assistance?
    -- Select One --ExcellentAbove averageAverageBelow averagePoorN/A
16. 6. How would you rank the process?
    -- Select One --SimpleSomewhat SimpleSomewhat DifficultDifficult N/A
18. 7. Please rate your overall experience with us:
    -- Select One --ExcellentAbove averageAverageBelow averagePoorN/A
20. 8. Would you like a supervisor to contact you?
    -- Select One --YesNo
22. Customer Name
23. Customer Phone
25. 9. Additional Comments:
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

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