AODA Customer Feedback Form AODA Customer Feedback Form Accessibility for Ontarians with Disability Act (AODA) Customer Service Feedback Form. MyRate Energy Inc. (“MyRate”) values our employees, and customers and we strive to meet everyone’s needs. We are committed to providing quality goods and services that are accessible to all persons that we serve Your feedback is important in helping us improve accessible services at MyRate. Please take a moment to complete this feedback form and let us know how we are doing. Date of Visit Time of Visit What was the purpose of your visit today? Did we respond to your customer service needs today?YesNo If no, please explain: Was our customer service provided to you in an accessible manner? YesNo If no, please explain: Did you have any problems accessing our goods or services? YesNo If no, please explain: Please add any other comments/suggestion you may have: Please provide us with your contact information below (optional): (Any personal information is collected pursuant to Ontario Regulation 429/07, the Accessible Standards for Customer Service and will be used strictly for the purpose of responding to your feedback) Full Name Mailing Address Telephone Number Email Address Would you like to be contacted by the Human Resources Department at MyRate?YesNo Customers can expect to hear back within five (5) business days from date of receipt. Response time to the feedback will depend on the issue, but will not exceed fifteen (15) business days unless there are extenuating circumstances involved. *If yes, please ensure you complete the contact information above. How would you like to be contacted? TelephoneEmailMail