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: