Question - how are we doing?

I love Google forms for doing some very simple customer/donor/client advocacy research and relationship discovery. Here is a sample form from a non-profit (some of our NFP friends lead the way when it comes to caring for their donors).

 How Are We Doing?

Feedback Form for Clients, Families and Caregivers

Private, Confidential and Secure

At ErinoakKids we strive to provide quality care and services to clients and families. We need your feedback to continuously improve and serve you better. Fields marked with an asterisk (*) must be completed.

*Are you an ErinoakKids client, family member or caregiver?

           ----Please Select----             Client             Family member             Caregiver          ----Please Select----  select

Name of Service (e.g. physiotherapy, speech language therapy, autism services):

Location where you receive services:

           ----Please Select----             Brampton - New Site             Halton/Oakville - New Site             Mississauga - New Site          ----Please Select----  select

*Area(s) for Improvement, Suggestions or Compliments:

Thank you for your valuable feedback!

You can give us your feedback anonymously, but we encourage you to provide your contact information so that we can follow up with you.

*Would you like to be contacted for follow-up?

Yes

No

Salutation

           ----Please Select----             Mr.             Ms.             Mrs.          ----Please Select----  select

First Name

Last Name

Phone Number

Use format 555-555-5555