Skip to Main Content
Loading
Loading
County Government
Departments
Services
Business
Things to Do
Search
Home
Form Center
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
Aging
Behavioral Health
Children and Family Services Foster Care - I want to help
Contests
District Attorney
Health
Parks
Planning and Development Forms
Sheriff
Suffrage 100
Test
Treatment Court Forms
Workforce Development Forms
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Website Survey
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Thank you for taking the time to tell us about your experience with the ADRC website. Your feedback is so meaningful to us. The more information you provide, the better we can understand what is working well for people and what can be improved. You may also call us at 262-605-6646 or email at
[email protected]
How often have you visited the ADRC Website?
Select one best answer:
Once
2 - 4 visits
6 or more visits
How confident are you using computers?
Select one best answer:
Very Confident
Confident
Not Confident
What were you looking for on your most recent visit to the website?
How easy was it to find what you were looking for?
Select one best answer:
Very Easy
Easy
Not Easy
What part of the website was most useful to you?
What were you hoping to find that you could not?
How clear and understandable was the content?
Select one best answer
Very Clear
Clear
Not Clear
How likely is it that you will return to the ADRC Website?
Select one best answer:
Very Likely
Likely
Not Likely
If you are willing to tell us a little more about yourself, please answer the following questions.
How would you best describe yourself?
Select one best answer:
Older person (age 60+)
Person with a disability (age 18 - 59)
Caregiver of an older person or person with a disability
Family or friend of an older person or person with a disability
Professional
Other
What is your gender?
Female
Male
Other
What is your race or ethnicity?
Select one best answer:
African American
Asian
Caucasian
Hispanic
Pacific Islander
Native American
Other
What is the highest level of education you completed?
Select one best answer:
Less than 6th grade
Between grade 6 - 9
Between grade 10-11
High School (grade 12)
Some college - no degree
Associate degree
Bachelor degree
Master degree
Doctorate degree
Thank you for sharing your thoughts with us!
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
* indicates a required field
Sheriff
Circuit Court
Employment
Elections
County Budget
Committees
Public Health
Public Safety
Sheriff's Department
Agendas & Minutes
Past Records
Parks
Public Green Spaces
Maps
Locate GIS Maps
Property & Taxes
County Information
Appointment Scheduler
Book a Time
Employment
County Jobs
Veteran Services
Division Resources
Notify Me
County Policies
Staff Directory
Zoning / Permitting
FAQs
Employment Opportunities
/QuickLinks.aspx
Contact Us
Site Map
Terms of Use
Copyright
Government Websites by CivicPlus®
/QuickLinks.aspx
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow