Satisfaction Survey

1. Please leave us your contact information

Name*:

Company:

Address:

Address 2:

City/Town:

State

ZIP/Postal Code:

Email Address*:

Phone Number*:

2. Did Assurance Restoration and Construction Inc. clearly explain what to expect throughout the restoration process?

Yes

No

Comment (optional)

3. Were technical staff in uniform and pleasant when addressed?

Yes

No

Comment (optional)

4. Did Assurance Restoration and Construction Inc. clean up at the end of each visit and explain the progress of your job?

Yes

No

5. Were you informed of your schedule and was it adhered to?

Yes

No

Comment (optional)

6. When was the job completed?

mm

dd

yyyy

/ /

7. Did the staff communicate regularly with you?

Yes

No

Comment (optional)

8. Would you recommend Assurance Restoration and Construction Inc. to your family and friends?

Yes

No

Comment (optional)

9. Did the completed work meet your expectations?

Yes

No

Comment (optional)

10. Can we use your comments in future advertising?

Yes

No

Comment (optional)

11. Is there anything you would like to mention that would improve our service to our future customers? (please explain)