Feedback Form Date of Visit: Time of Vist: What was the purpose of your visit today? Did We respond to your customer service needs today? Yes No If no, please explain: Was our customer service provided to you in an accessible manner? Yes No If no, please explain: Did you have any problems accessing our goods and services? Yes No If yes, please explain: Please add any other comments/suggestions you may have: Please provide us with your contact information below: Any personal information is collected pursuant to Ontario Regulation 429/07, the Accessible Standards for Customer Service and will be used strictly for the purpose of responding to your feedback. Name: E-mail Telephone Number: Mailing Address: Would you like to be contacted regarding your feedback? Yes No If yes, please ensure you cimplete the contact information fields above. How would you like to be contacted? Telephone E-mail Mail How may we ensure this contact method meets your disability requirements? Large font Submit
