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2. Please tell us about your recent experience with the City.
4. What is your primary reason for contacting the City?*
6. What department were you contacting?*

   1. Budget and Evaluation
   2. Business Inclusion and Advancement
   3. City Attorney
   4. City Council
   5. City Link
   6. City Manager
   7. City Secretary
   8. Community Development
   9. Emergency Management
   10. Engineering
   11. Financial Management Services

   1. Fire
   2. Human Relations
   3. Human Resources (HR)
   4. Information Services (IS)
   5. Inspections
   6. Marketing and Communications
   7. Mayor
   8. Performance and Accountability
   9. Planning
   10. Planning and Development Services

   1. Police
   2. Property Facilities Management
   3. Public Assembly Facilities
   4. Recreation and Parks
   5. Sanitation
   6. Sustainability
   7. Traffic Field Operations
   8. Transportation
   9. Utilities
   10. Winston-Salem Transit Authority (WSTA)
8. How would you rate the overall level of service received?*

   (With 5 being Excellent and 1 being Unacceptable)

   1. 1
   2. 2
   3. 3
   4. 4
   5. 5
10. If poor or unacceptable, please explain.
14. Do you know the name of the staff member you came in contact with? If so, please provide it.
    (Name Optional)
16. Please rate staff members on the following:
    (With 5 being Excellent and 1 being Unacceptable)
18. Professionalism*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
19. Knowledge*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
20. Courtesy*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
22. Communication*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
23. Promptness*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
27. Your Contact Information
    (Optional)
29. First Name
30. Last Name
32. Phone Number
33. Email Address
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field