Form Center

2. By completing this form, you will be assisting the Water Department by providing useful information on how service to our customers can be enhanced. It is not necessary to provide your name or address, as anonymous submissions will be accepted. When completed, please press the Submit button, or if you prefer, print it out and mail to the address provided at the end of the survey.
4. Demographic Questions
6. How long have you been a utility customer of the City of
   North Richland Hills?*

   1. Less than a Year
   2. 1-3 Years
   3. 4-10 Years
   4. 10+ Years
7. What is your age?*

   1. 18-24
   2. 25-34
   3. 35-44
   4. 45-54
   5. 55-64
   6. 65+
8. Do you receive a paper bill or electronic notification?*

   1. Paper Bill
   2. Electronic Notification
10. Bill Appearance Questions
    Please select the response that most accurately reflects your opinion for each statement.
12. My bill is easy to read.

    1. Agree
    2. Disagree
13. My bill contains all necessary information.

    1. Agree
    2. Disagree
14. I believe the bill could use some improvements.

    1. Agree
    2. Disagree
16. I recommend the following changes to enhance the appearance of my bill or electronic notification.
18. Customer Service Questions
    Please select the response that most accurately reflects your opinion for each statement.
20. The reason for your most recent office visit or phone call:

    1. New Water Service
    2. Pay Water Bill
    3. High Bill Dispute
    4. Disconnect Service
    5. Payment Extension
    6. Reconnect Service after Disconnection
    7. Other
    8. Did not contact office
21. I was properly greeted by office staff in a timely manner.

    1. Agree
    2. Disagree
22. The quality of the service I received was excellent.

    1. Agree
    2. Disagree
24. The clerk was knowledgeable about the subject.

    1. Agree
    2. Disagree
25. I received an adequate resolution to my issue in a
    timely manner.

    1. Agree
    2. Disagree
26. The Utility Customer Service Division does a good job
    serving the customers of North Richland Hills.

    1. Agree
    2. Disagree
27. 
    
29. I think these suggestions could improve customer views of the Water Department:
31. What improvements would you most like to see implemented:
33. Contact Information
35. Would you like a member of the Water Department to contact you?

    1. Yes
    2. No
37. If you answered yes, please provide your contact information:
39. Name:
41. Telephone Number:
42. Email Address:
44. 
    If you have any additional concerns, please contact us:
    817-427-6200

    City of North Richland Hills

    Water Department

    PO Box 820609

    North Richland Hills, TX 76182-0609

46. 
    
48. 
    
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field