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Client Survey
Please take a few moments to tell us what we're doing right or wrong – and how can we serve you better. Please be assured that we take your comments and suggestions very seriously.
l. Please identify yourself
Name
*
Address
*
City
*
State
*
Zip
*
Email
*
Area Code
*
Phone
*
Would you like a call from us?
Yes
No
ll. Please indicate your level of satisfaction for each category
Excellent
Fair
Poor
Convenient Office Hours
Excellent
Fair
Poor
Polite Telephone Response
Excellent
Fair
Poor
Prompt Telephone Call Return
Excellent
Fair
Poor
Prompt Policy Delivery
Excellent
Fair
Poor
Competitive Price Structure
Excellent
Fair
Poor
Easy-to-Read Correspondence
Excellent
Fair
Poor
Professional Sales People
Excellent
Fair
Poor
Responsive Customer Service
Excellent
Fair
Poor
Prompt Claim Response
Excellent
Fair
Poor
Professional Claim Handling
Excellent
Fair
Poor
lll. For the following questions, please check "YES" or "NO". (If "YES" Please Explain)
1. Should Additional Services Be Made Available?
Yes
No
2. Should Our Service Days or Office Hours Be Expanded?
Yes
No
3. Would You Prefer More Frequent Contact Or Coverage Hours?
Yes
No
lV. In the spaces provided, please tell us:
What You Most Like About Doing Business With Us:
What You Least Like About Doing Business With Us:
What is The Most Important Improvement You Would Like Us To Make?