Accessible customer service feedback

Providing Goods and Services to People with Disabilities

Thank you for visiting the city of Clarence-Rockland. We value all of our customers and strive to meet everyone's needs. Please fill this feedback form and let us know how we can improve our customer service.

Please tell us about your visit :

(date/time)

Did we respond to your customer service needs on this visit?

Yes

Somewhat

Was our customer service provided to you in an accessible manner?

Yes

Somewhat

If no, please explain :

Did you have any problems accessing our goods and/or services?

Yes

Somewhat

If yes, please explain :

Please add any other comments you may have :

I would like to receive a response to my comments :

Yes

If yes, please provide your contact information below :

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Providing Goods and Services to People with Disabilities