Customer Satisfaction Survey

Contact Information

First Name:*

Last Name:*

Email:*

Confirm Email:*

Phone:*

Address

Address:*

City:*

State:* -select- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NV NH NJ NM NY OH OK OR PA RI SC SD TN TX UT VT VA WA WI WV WY

Zip/Postal Code:*

Survey Questions

Date of Service:

Invoice Number:

Store Location:* Please Select Augusta, ME Bangor, ME Barre, VT Berlin, NH Biddeford, ME Brattleboro, VT Brunswick, ME Concord, NH Damariscotta, ME Dover, NH Ellsworth, ME Exeter, NH Farmington, ME Hooksett, NH Houlton, ME Keene, NH Laconia, NH Lewiston, ME Littleton, NH Millinocket, ME Nashua, NH Newport, VT North Conway, NH Portland, ME Portsmouth, NH Presque Isle, ME Raymond, ME Rumford, ME Rutland, VT Salem, NH South Burlington, VT South Paris, ME Springvale, ME St. Albans, VT Waterville, ME West Lebanon, NH Westbrook, ME

Name of Technician:

Where did you hear about us?* Please Select -select- Banner Ad Search Engine (specify below) Other Web Site (specify below) Friend/Colleague Message Board (specify below) Newspaper (specify below) Magazine (specify below) Post Card Radio/TV (specify below) Saw one of your vans Trade Show (specify below) Yellow Pages Home Show Prior Customer Insurance Auto-mechanic Location\Sign General Knowledge/Reputation Lawn Signs Other (specify below)

Will you call us again for service?: Yes No

How would you rate our office personnel?

1. Professional
Poor OK Good Great

1. Courteous
Poor OK Good Great

1. Helpful
Poor OK Good Great

1. Cheerful
Poor OK Good Great

1. Informative
Poor OK Good Great

1. Knowledgeable
Poor OK Good Great

How would you rate our technicians?

1. Prompt
Poor OK Good Great

1. Professional
Poor OK Good Great

1. Courteous
Poor OK Good Great

1. Cheerful
Poor OK Good Great

1. Appearance
Poor OK Good Great

1. Quality
Poor OK Good Great

1. Work Area Cleaned
Poor OK Good Great

8. Questions or comments concerning your experience with us may be entered below.

Would you like to receive informational email updates?

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