Customer Satisfaction

Organizational Development has designed two set of scan forms, standard and with client change, that counties can use to meet their customer satisfaction reporting requirement.

Data collection options for customer satisfaction fall into three categories. First, there is a set of “standard forms” without an outcome section. Second, there is a set of “plus outcomes” forms that includes both customer satisfaction and an outcome section. Finally, in certain situations it may be appropriate to use the online version of the standard customer satisfaction form. All of these options count toward meeting the state requirement for customer satisfaction reporting.

Important Notes: All forms on this page meet the state requirement for reporting customer satisfaction. The standard customer satisfaction form has been revised as of September 2012. Please discard all previous versions and use the revised version.

Standard Customer Satisfaction Forms

These forms have the state-required questions for customer satisfaction, other customer satisfaction questions, and a few open-ended questions for program improvement purposes.

** Reads at a Flesch-Kincaid Grade Level of 6.4

Customer Satisfaction Plus Client Change Forms

These forms have the state-required questions for customer satisfaction plus one or more sections for client change. Formerly these were legal size but have been reduced to letter size.

Change in understanding is typically measured at the conclusion of a one-time program but can be used with a program series as well:


Standard Customer Satisfaction Form Online

The standard customer satisfaction form implemented as a web survey. Appropriate in limited situations.

Organizational Development has developed a new option for program participants to complete one version of the customer satisfaction survey. The standard customer satisfaction survey has been set up as an online survey on Qualtrics. Program participants can be directed to the link to complete the survey.

Is this appropriate for all Extension program events?
No. In most cases, with scan forms you’ll quickly capture responses from most or all participants as the program concludes. The web option is more appropriate in situations in which you have an email address for all participants, they all have web access, and you have continual contact with the participants (i.e., volunteers, newsletter list, program series).

How do I get started?
You MUST do the following or you will LOSE your data:

  • Complete and return this cover sheet to Organizational Development BEFORE directing participants to the web survey
  • Wait for Organizational Development to provided you with an EVENT ID.
  • Provide program participants with the URL (below) AND the event id. The event id is the first survey question and must be selected before proceeding to the remainder of the survey. This is the only way we can link survey responses to your specific event.

What are the links?

The URL for ADULTS is:

The URL for YOUTH is: