Accessibility Form

Customer Feedback on Accessibility
Central Lake Ontario Conservation (CLOCA) strives to meet the needs of all

of our customers. We use your feedback to make sure that we meet

reasonable expectations, provide our services to all our customers, and

make improvements where necessary.

NOTE: This form is available in alternative formats upon request. Completed

forms will be emailed to Rose Catulli, Director of Corporate Services,

rcatulli@cloca.com, 905-579-0411 ext. 148.
Contact Information: Optional
Name: *

First Name Last Name
Date:

Month Day Year
Address *

Street Address

Street Address Line 2

City Province

Postal / Zip Code
E-mail
Phone Number (Day)

Area Code Phone Number
Phone Number (Evening)

Area Code Phone Number
Preferred Method of Contact

Mail Email Phone
1) When did you visit CLOCA (date & time)?
2) What area of CLOCA did you visit?
3) Did we respond to your customer service needs

Yes No
4) was our customer service provided in an accessible matter

Yes Somewhat NO
4b) Please Explain:
5) Did you have a problem accessing our services

Yes Somewhat NO
5b) Please Explain:
Other Comments
Enter the message as it's shown *
Should be Empty: