Customer Survey Form

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Customer Satisfaction Survey
Name

First
Last
Address

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Overall, how would you rate the product? *
 Very good 
 Good  
 Neutral 
 Bad 
 Very Bad 
Please explain
Overall, how would you rate the value of our work? *
 Very good 
 Good  
 Neutral 
 Bad 
 Very Bad 
Please explain
How long have you used our product? *
 Less than a month 
 3-6 months 
 1-3 years 
 More than 3 years 
 Never used 
 Cannot remember 
Please explain
How would you rate our customer service?
 Very Good 
 Good 
 Neutral 
 Bad 
 Very Bad 
Please explain
How would you rate our warranty service?
 Very Good 
 Good 
 Neutral 
 Bad 
 Very Bad 
Please explain
How would you rate our field evaluators?
 Very Good 
 Good 
 Neutral 
 Bad 
 Very Bad 
Please explain
How would you rate our crews and clean up?
 Very Good 
 Good 
 Neutral 
 Bad 
 Very Bad 
Please explain
Would you recommend our product to your neighbors? *
 Definitely 
 Probably 
 Not Sure 
 Probably Not 
 Definitely Not 
Please explain
May we post your review on our websites? *
 Yes 
 No 

Additional Information (Optional)

What was your favorite thing about the product?
What was your least favorite thing about the product?


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