Customer Opinion Survey

We would appreciate your help in rating the service you receieved from us. A moment of your time in completing this survey will help us serve you better in the future.

*Please fill in all required fields.

*First Name: *Last Name:
*Address:
*City: *State: *Zip:
*Phone: (e.g. 000-000-0000)
Fax: (e.g. 000-000-0000)
*Email:
*Insurance:
*Agency:
*Policy#:
 
1. How did you hear about us? Select all that apply.
Yellow Pages Friend Other:
Insurance Agent Sign  
Radio Web Site   (If checked, enter other above)
Previous Service Television    
2. When you called for service, was your phone call answered promptly and courteously?
Yes No NA
3. Were you satisfied with the scheduling of your service request?
Yes No NA
4. Was the work performed to your satisfaction?
Yes No
5. Was the technician polite, neat and clean in appearance?
Yes No NA
6. Did the technician clean up your automobile after the service was performed?
Yes No NA
7. Would you recommend us to others?
Yes No
8. Was the staff friendly and knowledgable?
Yes No NA
9. How would you rate your overall service experience with us?
Very Satisfied Satisfied Dissatisfied
10.Did the Customer Service Representative ask if you wanted new wiper blades?
Yes No NA
11.Did the Customer Service Representative ask you if you need an inspection sticker?
Yes No NA
12.Did the Customer Service Representative give you the option to fill out this comment card on our website?
Yes No NA
13. Did the CSR ask for your e-mail adress?
Yes No NA
Additional Comments are welcome

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