Department of Love Feedback Form

Your honest feedback will help us to serve you better and enable us to work on improving our service standards.

First Name *

Last Name *

Email *

Phone

Who was your service provider? *

Please rate the following statements according to this scale:

1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly Agree

I am satisfied with my experience with the Love Department:

1 2 3 4 5

I am satisfied with the performance of my service provider:

1 2 3 4 5

I find the service provided to be valuable or useful:

1 2 3 4 5

I feel more loved or valued as a result of the service provided:

1 2 3 4 5

I have a more positive outlook on life as a result of the service provided:

1 2 3 4 5

I am more likely to help others as a result of the service provided:

1 2 3 4 5

I support the Love Department and the services that it provides:

1 2 3 4 5

Comments and/or suggestions for the Love Department

* These fields are required.