CLIENT FEEDBACK FORM

We value all of our clients and strive to meet everyone’s needs, including those with disabilities. Thank you for taking the time to share your feedback with Siskinds. Your comments are important to us, because we want to make your experience with Siskinds the best it can be.

You may download this form as a PDF here and submit this form in person at Siskinds or mail it to Siskinds LLP, 680 Waterloo Street, London, ON N6A 3V8 to the Attention of the Human Resource Manager.

Date of Service:	Date and timeNow
Type Of Service:
Description of the event / concern:
Names of People Involved:
Did we respond to and meet your customer service needs today?:
Yes No Somewhat
Comments:
Was our customer service provided to you in an accessible manner?:
Yes No Somewhat
Comments:
Did you have any problems accessing our services?:
Yes No Somewhat
Comments:
Would you like to be contacted?:
YesNo
Please complete your contact information below only if you would like a reply.
First Name:
Last Name:
Address:
City:
Province:
Postal Code:
Daytime Phone:	() -Second partThird part
Email:
Thank you

Siskinds LLP is collecting the personal information you provide on this form so we can respond to your feedback. If you have any questions about the collection, use and disclosure of your personal information by Siskinds LLP, please contact the Human Resource Manager.

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Southwestern Ontario.

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