Tell Us What you Think

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Please correct the field(s) marked in red below:

1
Date of Visit
 *
2
Name of Facility
3
Name of program or event
Rate the facility: (1 to 5 with 5 being the highest rating)
4
Cleanliness
Cleanliness
5

Safety

Safety
6

Fees

Fees
7

Overall

Overall
Rate the staff/instructor: (1 to 5 with 5 being the highest rating)
8

Availability

Availability
9

Knowledge

Knowledge
10

Overall

Overall
11
Name of staff you interacted with
12
How did you hear about us?
How did you hear about us?
13

What other programs/services would you like to see offered?

14
Comments:
15
Name and Phone Number (Optional)
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