Comment Card

Please take a moment to fill out this survey to rate your experience with our company. We strive to make your experience a pleasant one and your comments are important to us to better serve you.

* denotes a required field
Name: *
Street Address:
City:
State:
Zip Code:
Phone Number:
Email Address: *
Value of Work Done:	Excellent Good Fair Poor
Technician's Neatness / Cleanliness	Excellent Good Fair Poor
Courtesy of Technician / Office Personnel	Excellent Good Fair Poor
Contacted Prior to Appointment Time?	Yes No (Explain)
On Time for Appointment?	Yes No (Explain)
Estimate Given? / Estimate Accurate?	Yes No (Explain)
How Did You Hear About Us?
Would You be Interested in a Service Agreement?	Yes No
Would You Call Our Company Again?	Yes No
Would You Like to Recieve Our Newsletter?	Yes No
Comments (Problems / Prasies):
Referrals (Name and Telephone Number):