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Customer Satisfaction Survey
* Note: To select multiple answers, please hold the Control key while clicking the mouse over your choices.
* First Name
* Last Name
* Email
* Date of Service
* Service Address
Time of Service
Choose One
8 am
9 am
10 am
11 am
12 pm
1 pm
2 pm
3 pm
4 pm
5 pm
6 pm
Other
How did you hear about our business?
Choose One
Yellow Pages
Radio
TV
Newspaper
Web Search
Referral
Other
Name of the service technician that assisted you?
General Questions:
* Level of satisfaction with the service you received today?
Choose One
Very High
High
Low
Very Low
* What is your overall impression of our business?
Choose One
Great
Good
OK
Poor
Office Staff Ratings:
* Professional
Choose One
Great
Good
OK
Poor
* Courteous
Choose One
Great
Good
OK
Poor
* Helpful
Choose One
Great
Good
OK
Poor
* Cheerful
Choose One
Great
Good
OK
Poor
* Informative
Choose One
Great
Good
OK
Poor
* Knowledgeable
Choose One
Great
Good
OK
Poor
Suggestions for improving our office support?
Technician(s) Ratings:
* Promptness
Choose One
On Time
Less than 15 minutes late
More than 15 minutes late
Late but called
No show
* Professionalism
Choose One
Great
Good
OK
Poor
* Appearance
Choose One
Great
Good
OK
Poor
* Quality of Work
Choose One
Great
Good
OK
Poor
* Cleanliness
Choose One
Great
Good
OK
Poor
* Demeanor
Select As Many As Apply
Respectful
Cheerful
Informative
Knowledgeable
Patient
Suggestions on how we might improve our overall customer service?
*
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