Customer Survey Customer Survey Form Name * Address * City Postal Code Email * How would you describe your visit to our facility? —Please choose an option—N/AExcellentGoodFairPoor Were you satisfied with the service received? —Please choose an option—N/AYesNo Was our staff friendly, efficient, and knowledgeable? —Please choose an option—N/AYesNo Was the time estimate given for your work request accurate? —Please choose an option—N/AYesNo If additional work was necessary, were you consulted first? —Please choose an option—N/AYesNo Did you find our facility to be neat and clean? —Please choose an option—N/AYesNo Have you visited our facility in the past? —Please choose an option—N/AYesNo Would you visit our facility in the future? —Please choose an option—N/AYesNo What is your main reason for visiting our Website? —Please choose an option—SpecialsProdict Research/PurchaseContact InfoOther Other: I visited the website for: What would you change about our facility? Other comments/suggestions Receive Offers YesNo
