Customer Service Survey
Date *
MM
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DD
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YYYY
Time
:
Please tell us the reason for your visit: *
Your answer
*
1 = below average, 3 = average, 5 = exceptional
1
2
3
4
5
How professional is our service?
How efficient is our service?
How responsive are our staff members?
How knowledgeable are our staff members?
Overall, are you satisfied with your visit?
Please explain your overall rating: *
Your answer
Please provide us with any other comments about our service:
Your answer
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