Customer Satisfaction Survey
Please complete the following evaluation of the Work Incentives Planning & Assistance services
that you have received and return it in the enclosed postage paid envelope. Your input will
assist us in our efforts to provide high quality customer services. Please contact
_____________________________ with any questions or concerns, or if you require additional
Community Work Incentives Coordinator’s (CWIC) name:
Did your Community Work Incentives Coordinator (CWIC) provide clear and understandable
responses to your questions?
Did your CWIC respond in a timely manner to your request for information?
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