Customer Survey

Customer Survey
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name
E-mail Address*
Web Site URL
Street Address*
City
State/Prov
Zip/Postal Code
Country*
Home Phone
Business Phone
Knowledge of Sales Rep
A Unsatisfied
B Satisfied
C Very Satisfied
Knowledge Of Employees
A Unsatisfied
B Satisfied
C Very Satisfied
Was Start Date On Schedule
A Unsatisfied
B Satisfied
C Very Satisfied
Quality Of Work
A Unsatisfied
B Satisfied
C Very Satisfied
Job Site Cleanliness
A Unsatisfied
B Satisfied
C Very Satisfied
Cost of Job
A Unsatisfied
B Satisfied
C Very Satisfied
Was Job Finished On Schedule
A Unsatisfied
B Satisfied
C Very Satisfied
Was Customer Service Helpful
A Unsatisfied
B Satisfied
C Very Satisfied
Overall Job Performance
A Unsatisfied
B Satisfied
C Very Satisfied
Would You Referr A Friend Or Family
A Likely
B Unlikely

Please enter the word that you see below.

  

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