Warning! Please do not use this form to report issues of an emergency nature or for conditions requiring an immediate response. If your issue is an emergency, please use the telephone and dial 911.

The Township of Rockaway strives for customer satisfaction and by letting us know how we are doing helps us reach that goal. Please complete the survey and submit it. We appreciate your time and comments.

Contact Information

First Name

Last Name

Business Name

Email*

Daytime Phone

Fax

Address

City

State

ZIP

What date did you visit us?

Was someone ready to help you within a reasonable time frame?

Yes

No

Did the employee actively listen to your request, without interrupting?

Yes

No

Did the employee have the knowledge to solve your issue?

Yes

No

Did the employee ensure all of your issues were resolved?

Yes

No

Did he/she provide you with additional information or options(beyond what was asked)?

Yes

No

Was your issue handled professionally?

Yes

No

What department did you visit?

Utilities (Water, Sewer) Tax Collector Clerk Court Tax Assessor Fire Health Planning Zoning Construction Engineering Department of Public Works Police Administration

Please provide the name of the employee you spoke to.

Did the employee show interest/concern for you?

Was the employee upbeat and friendly?

Yes

No

Did the employee use positive statements (e.g. What can I do for you)?

Yes

No

Was your request handled within an effective time frame?

Yes

No

Please explain why you visited today.

Notes

If you send us a message, you'll receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Information we receive may be considered public information which is subject to disclosure under current state law. Learn more about our Privacy Policy.

Thank you for taking the time to fill out our customer survey.