Customer Satisfaction Survey
* indicates required field
R.O. Number :
*
First Name:
*
Last Name:
*
Address:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
What is the best way to contact you? (please select all that apply)
Email:
*
Home Phone:
Work Phone:
Cell Phone:
Date of Service:
January
February
March
April
May
June
July
August
September
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Service Writer:
Please Select
Chuck Wise
Trever Wise
Lorenzo Baker
Ben Larson
Based on your overall service experience, would you recommend European Auto Body, Inc. to your friends, family and colleagues for their collision repair needs?
Yes |
No - If no, why not?
How satisfied were you with the service you received from our staff?
Very Satisfied |
Satisfied |
Not Satisfied
What could we have done differently to improve your experience with us?
The service staff listened and understood my needs.
Strongly Agree |
Agree |
Disagree |
Strongly Disagree
How satisfied are you with the quality of work performed on your vehicle for this repair order?
Very Satisfied |
Satisfied |
Not Satisfied |
Very Dissatisfied:
What could we have done to increase your satisfaction with the work performed on your vehicle?
Was your vehicle available at the time it was promised?
Yes |
No
How many visits did it take to have your most recent service needs taken care of?
1 Visit |
2 Visits |
3 Visits |
4 or More Visits
If your vehicle was not repaired on the first visit, why not?
Part not Available |
Could not Identify Problem
Work not Completed |
Service Schedule too Full to Accept Work
Additional Comments regarding your service experience and/or quality of the repairs on your vehicle.
Validation Key:
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European Auto Body