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Customer Survey Form

 1. What influenced your decision to choose this company?

   Advertisement      Regular Customer    

   Yellow Pages         Friend, Neighbor, Relative   

   Other

 

 2.  Was your sales/service representative courteous?   Yes    No

     If No, Please explain: 

 

 3.  Were you satisfied with the way our services, procedures, and pricing
structure were explained to you?       Yes     No

If No, Please explain:

 

 4.  Would You recommend our company to others?     Yes     No

 

 5.  What, in your opinion, could we do to improve our service? 

 OPTIONAL:

 Contact Name:

 

 Phone Number:

   - -

 Email Address:

  

 

 Other: 

 
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