Water and Utility Service Survey

Water and Utility Service Survey — Form Fields

This surveys template includes 9 fields. Gauge customer satisfaction with water quality, utility billing, service reliability, and conservation programs. Free to customize and use on ZenBuild.

• Primary utility provider type (dropdown selection, required) — options: Municipal, Private company, Cooperative, Well and septic, Shared building
• Overall satisfaction with water and utility services (rating, required)
• Water quality and taste (rating, required)
• Billing accuracy and clarity (rating, required)
• Customer service responsiveness (rating, required)
• Have you experienced service outages in the past year? (multiple choice, required) — options: Yes frequently, Yes once or twice, No
• Do you participate in any conservation programs? (multiple choice, required) — options: Yes, No but interested, No
• Utility concerns you have (checkboxes, optional) — options: Water quality, High bills, Billing errors, Outages, Pressure issues, Poor customer service, Environmental impact, Infrastructure age
• What would improve your utility service experience? (long text, optional)