PERSONS WITH DISABILITIES CUSTOMER SERVICE FEEDBACK FORM

Mariposa Folk Foundation would appreciate the comments and feedback of our clients/customers with disabilities. Persons with a disability may communicate in writing by filling out this form, or via email or a telephone call

Date*
MM slash DD slash YYYY
Location
Name of Person visited:*
First Last
Please describe your experience:*
Please provide any suggestions, comments or other information that may help us improve the customer service experience for persons with a disability.
Please provide your name and preferred method of contact:*