Customer Survey

As many companies grow larger, the importance of customer satisfaction is often overlooked. THIS IS NOT SO WITH US. Please help us maintain our high standard of quality service by answering the following questions. Please rate your satisfaction on the following:

Completely Satisfied: 5 | Satisfied: 4 | Neither: 3 | Dissatisfied: 2 | Completely Dissatisfied: 1

1. Our phone representative:		5 4 3 2 1
2. How the work was performed:		5 4 3 2 1
3. Our employee appearance:		5 4 3 2 1
4. Our employee attitude:		5 4 3 2 1
Of the four satisfaction ratings, which one is the most important to you?

Did our employee(s) wear protective shoe coverings?
Yes No

The service charge was ...
More Than Expected About Right Less Than Expected

Would you use us again?
Yes No Maybe

Would you refer us to a friend?
Yes No Maybe

Technician's Name:

Additional Remarks:

Do we have your permission to use the above comments in our Dixie Electric Company advertising and/or marketing? To identify you we will use your first name, first initial of last name and city of residence only.

Yes No

Your Name (required):
Your Email (required):
Date (required):

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