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  • Customer Survey Form

Customer Survey Form

At North Water, we are constantly striving to better the services and expectation we deliver to our clients. Thank you for taking the time to complete our survey so we can improve our services which we provide. We value your feedback and appreciate your time.

Fields with * are required.

1. Please identify yourself *


Owner/Employee of Regulated Company

Environmental Group Representative

Public/Elected Official

Industry/Association Representative

Neighborhood/Community Representative


Other (please describe)

2. How long have you been using our services? *

Less than 6 months

6 months to less than 1 year

1 year to less than 3 years

3 years to less than 5 years

5 years or more

3. How often do you use our services?

# Daily Weekly Monthly Quarterly Semi-Annually Annually
Drinking Water
Non-Potable Water
Solid Chemical Materials
Biological Tissue
Special Projects

4. How satisfied are you? (on a scale of 1 to 5 with 5 being very satisfied)

# 5 4 3 2 1 No Opinion
With collection of samples?
With our staff's knowledge?
With our office personnel's professionalism?
With our field technician's professionalism?
With our sample receiving technician's professionalism?
With how we handle your telephone calls or email inquiries?
With the timeliness of our response to customer complaints?
With the timeliness of our delivery of sample results?
With the timeliness of issuing reports?
In comparison to other companies offering the same services?
Our pricing in comparison to other companies offering the same services?
Your overall level of satisfaction with us? *

5. Customer Info (optional)

Please enter the information indicated below for our records and/or if you would like to be contacted regarding your responses.

By entering my personal information, I consent to receive email communications from the survey author’s organization based on the information collected.