Customer Service Survey

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The California Health and Human Services Agency and the Department of Managed Health Care would like to provide you with the best possible service and your input is vital to our success. Please help us serve you and others better by taking a few minutes to answer the questions below. Thank you for responding.

What was the nature of your contact with us?
General Information Problem Resolution Technical Assistance
Permitting/Licensing Assistance Registration Assistance Other:

  Check As Appropriate
STATEMENTS Strongly Agree Agree Disagree Strongly Disagree No Comment Or N/A
Staff was courteous and helpful
Staff provided complete,
accurate information to you.
A timely response was provided.
My overall experience was positive.

Please complete the section below if your contact with us involved permitting/licensing/registration assistance.
The regulations were understandable.
The application instructions were understandable.
The permit/license/registration terms and conditions were understandable.

Please indicate the name(s) of any staff person you would like to commend:


Please use text only. HTML codes or links are not accepted.

If you feel we fell short in meeting your service expectations, please describe the situation, including name of the staff person involved and the date the incident occurred.

As a result of your experience with us, what service-related improvements can you recommend?

If you would like a response to your comments, please fill in your E-mail address below.
Your Name:
E-mail Address:
Daytime Phone:
Mailing Address:
Zip Code:

If you would prefer to print out this survey form and mail it to us Click Here.

Shelley Rouillard, Director
California Department of Managed Health Care
Attn: Customer Survey
980 9th Street, Suite 500
Sacramento, CA  95814-2725

Voice: (916) 324-8176
FAX: (916) 322-9430

California Health and Human Services Agency