Customer Interaction / Interview Tracking Application in Access

HOP Mobility Counselor Data Capture Tracking System. This solution will track customer feedback sessions. Can you provide some examples of your similar work? It will support 10 remote agents. Require basic report triggered by the selection of " Frail Elderly " 10 named user access Will be hosted off premise Application Content Number Object Type and Appearance Questions and Comments 1. Applicant Name Text Box First/ Last/ MI Dropdown Select / Mr. Ms. Etc 2. Demographic Information Age Select Box Gender Male Female Race Ethnicity Marital Status Married Divorced Single Family Status Retired Disabled Elderly Can you provide more descriptions or classifications of race and ethnicity categories? Are date ranges and/ or birthdates required to classify or quantify Elderly as a selection? 3. Contact Information Main Header / Label 4. Current Address Address Box / City/Sate/ZIP 5. Home Phone ### ### #### 6. Cell Phone ### ### #### 7. Work Phone ### ### #### 8. Damaged Property Address Address Box / City / Sate / ZIP 9. Property Address Location Description Dropdown Selection Choices Primary Secondary Tertiary 10. Assigned Consular Name Name Textbox 11. Date Referred To HOP Calendar Range Selection 2012 – 2015 12. Type Of Counseling Session Dropdown Box Selections Introductory Social Services Ongoing Mobility Closing Post Move Mobility Counseling 13. Type Of Contact Dropdown Selections Phone Home Visit Office Visit Mail E-Mail FAX Added Office Visit and Fax Contact. Is this needed? 14. Length of Session Dropdown Selections In 30 Minute Increments 0.5 Hrs 1.0 Hrs 1.5 Hrs 2.0 Hrs 2.5 Hrs 3.0 Hrs 3.5 Hrs 4.0 Hrs 4.5 Hrs 5.0 Hrs 5.5 Hrs 6.0 Hrs 6.5 Hrs 7.0 Hrs 7.5 Hrs 8.0 Hrs Max At 8.5 Hrs Is this range acceptable? 15. Date Of Session Calendar Selection 16. Case Notes From Session Comment Box How many text lines are required? 17. Consular Follow Up Action Comment Box How many text lines are required? 18. Application Program Tier Dropdown Box Tier 1 = 5-10 pts Tier 2 = 10-25 pts Tier 3 = 30+pts 19. HOP Relocation Assessment Date Calendar Selection 20. Assigned Realtor Name Only 21. Referrals To Other Services Comment Box How many text lines are required? 22. Applicant Decision Opt In Or Out Dropdown Box Opt In Opt Out 23. Reason For Opting Out Comment Box How many text lines are required? 24. Ownership Counseling Date Calendar Selection 25. Closing Date Calendar Selection 26. Move In Date Calendar Selection 27. Survey Date Calendar Selection 28. Details Of Counselor’s Accomplishments Comment Box How many text lines are required?