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| Name * |
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| Address * |
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| Phone Number * |
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| Email Address * |
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| Date of Service * |
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MM |
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DD |
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YYYY |
HH |
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MM |
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AM/PM |
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| Overall, how would you rate our service? * |
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Very good
Good
Neutral
Bad
Very Bad
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| What was your favorite thing about our service? |
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| What was your least favorite thing about our service? |
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| What did you think about the quality of our customer service based upon your interaction with our staff? * |
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Excellent
Good
Average
Bad
Extremely Bad
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| Was your vehicle serviced and delivered in a timely manner? * |
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Yes
Somewhat
No
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| Was your vehicle just as clean when you picked it up as it was when you initially brought it in? * |
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Yes
No
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| If you were required to sign a written estimate, was the signature process easy for you? * |
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Yes
No
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| What service did you receive? * |
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| Please provide us with a short explanation of what you had done to help us serve you better. * |
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| When you arrived at our shop were you waited on in a timely manner? * |
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Yes
No
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| Was the cost of the service or repairs reasonable within your expectations? * |
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Yes
No
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| How did you hear about us? * |
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Internet
Family or Friend
Word of Mouth
YellowPages
Email
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| If you heard about us on the internet, where did you find us? * |
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Google
Yahoo
Bing
Other Search Engine
Web Directory
Online Newspaper
Article Resource
Blog
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| Would you recommend our service to other people? * |
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Absolutely!
I’ll think about it.
Probably not.
Definitely not!
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| What can we do to improve the quality of our service, do you have any recommendations for us? |
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| Image Verification |
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