Form YG5984 "Environmental Health Services Survey" - Yukon, Canada

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Download Form YG5984 "Environmental Health Services Survey" - Yukon, Canada

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Rate (4.8 / 5) 14 votes
HOW ARE WE DOING?
Health and Social Services
Environmental Health Services
#2 Hospital Road, Whitehorse, Yukon Y1A 3H8
Why did you visit Environmental Health Services today?
Food Premises Permit
Sewage Disposal System Permit
Water Sample Submission
Other _________________________________________________________________________________________
Was staff courteous and helpful?
Did you receive service in a timely manner?
Good
Average
Poor
Good
Average
Poor
Was our website helpful?
Did we meet your expectations?
Good
Average
Poor
Good
Average
Poor
What can we do to improve our service?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Please provide your name and phone number if you would like somebody to contact you regarding this comment card:
Name _________________________________________________________ Phone Number _____________________
Thank you for helping us help you!
YG(5984EQ)F2 Rev. 04/2014
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HOW ARE WE DOING?
Health and Social Services
Environmental Health Services
#2 Hospital Road, Whitehorse, Yukon Y1A 3H8
Why did you visit Environmental Health Services today?
Food Premises Permit
Sewage Disposal System Permit
Water Sample Submission
Other _________________________________________________________________________________________
Was staff courteous and helpful?
Did you receive service in a timely manner?
Good
Average
Poor
Good
Average
Poor
Was our website helpful?
Did we meet your expectations?
Good
Average
Poor
Good
Average
Poor
What can we do to improve our service?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Please provide your name and phone number if you would like somebody to contact you regarding this comment card:
Name _________________________________________________________ Phone Number _____________________
Thank you for helping us help you!
YG(5984EQ)F2 Rev. 04/2014
SAVE
PRINT
CLEAR
SUBMIT BY EMAIL