Customer Survey

Contact Information

First Name:

Last Name:

Address:

City:

State/Province:

Zip/Postal Code:

Phone:

Email:

Location Visited:

1) How would you describe your visit to our facility?:

2) Were you satisfied with the service received?:

3) Was our staff friendly, efficient and knowledgeable?:

4) Was the time estimate given for your work request accurate?:

5) If additional work was necessary, were you consulted first?:

6) Did you find our facility to be neat and clean?:

7) Have you visited our facility in the past?:

8) Would you visit our facility again in the future?:

9) What is your main reason for visiting our Website?:

Specials
Product Research/Purchase
Contact Info
Other, I visited the website for:

10) What would you change about our facility?:

11) Other comments/suggestions::