Maintenance Survey

Service Satisfaction Survey

Service Technician's Name:

Resident's Address:

Telephone Number:

Date of Request

Date Request Completed

1=Very Dissatisfied; 2=Somewhat Dissatisfied; 3=Neither Satisfied or Dissatisfied; 4=Somewhat Satisfied; 5=Very Satisfied

Additional Comments

Was a notice left letting you know the work was completed?  yes no

If the work was not completed on the first request, was a note left explaining why and when we would return to complete the work?  yes no