Questionnaire: How did we do? How Did We Do? If you are human, leave this field blank. Name * Phone * Email * Would you like to be added to the mailing/emailing list for special promotions? * Yes No Date of Service Type of Service * Plumbing Heating AC Electrical OtherOther Name of Technician * Bill Dan Erik Guy Jason Justin Larry Matt Paul H. Ralph Nick Corky Josh Steve Jim Kevin Andy Joey How did you hear about us? * TV Social Media Our website Internet Newspaper Trucks in the neighborhood Radio - The Fan Existing customer/referral Radio- 3WS Other How did you hear about us? Please rate your experience: On a Scale of 1 - 5 #1 = Very Dissatisfied | #2 = Dissatisfied | #3 = Average | #4 = Satisfied | #5 = Very Satisfied Courtesy of Office Personnel * 1 2 3 4 5 Knowledge of Office Personnel * 1 2 3 4 5 Was appointment scheduled at your Convenience? * 1 2 3 4 5 Was the technician on time? * 1 2 3 4 5 Was the technician courteous & friendly? * 1 2 3 4 5 Rate the technician's appearance * 1 2 3 4 5 Condition of work area after work completed * 1 2 3 4 5 Were your questions/concerns answered to your satisfaction? * 1 2 3 4 5 Technician's knowledge of situation * 1 2 3 4 5 The value of service for price paid * 1 2 3 4 5 Please comment on overall experience with Gerard Plumbing & Heating Inc. Would you reccommend us to family and friends? * Yes No May we publish your comments? * Yes No Submit
