1. At the time you requested the packet did you have a lawyer?
yes no
2. Why did you request the packet (one or a combination of the following)?
Separated and wanted information Thinking about separating and wanted information Separated or thinking about separating and wanted to know more about Lawrence Pascoe Information was for a friend or relative Other
3. Did the packet fulfill your expectations?
If not why not?
4. What did you think of the packet in general?
Excellent Good Fair Poor
5. Did you read the articles?
Too complicated Not interested
6. Were the articles understandable?
7. Were the articles:
Too long Too short Just right
8. Did you find the articles overall helpful?
9. Did you have trouble completing the Matrimonial Information Form?
10. Did you like the fact that you can fill out this form prior to your appointment?
11. Are there any other topics that you would like to have discussed in the articles?
12. Did you read the articles?
13. Did you find the government pamphlets overall helpful?
14. Were the pamphlets understandable?
15. Were the pamphlets:
16. Did you find the information on cost and procedure helpful?
Do you have any comments on it?
17. Did you find the resume helpful?
18. Did you find the hourly rate:
Reasonable Too high Too low Comment
Reasonable Too high Too low
Comment
19. Did you like the concept of the Preference Questionnaire?
Your comments on it, including other preferences to ask?
20. How did you find out about the packet?
Telephone Book Clarion ad Courier ad Senior's ad Friend Other
21. Did you like the ad?
What did or didn't you like about it?
22. Do you like the idea of a survey contest?
23. How did you find out about the packet?
Telephone Book Already had another lawyer Didn't separate Chose another lawyer. If so, why? Other
24. Do you think that you will make an appointment?
25. Do you have any other comments?
Contact Information
Name Street Address City State/Province Zip/Postal Code Country Work Phone Home Phone E-mail Date January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , 1999 2000 2001 2002/option> 2003 2004 2005 2006 2007 2008 2009
**Note: Before submitting this form, you may want to save it to a file or print it out.
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