CUSTOMER SERVICE FORM
Service Survey
Please specify the type of account:
Please provide the following information:
Name:
Title:
Company:
E-Mail:
Phone Number:
Fax Number:
Please rate our ability to provide the following services:
Calls answered promptly
Outstanding Good Average Below Average N/A
Availability of employees
Outstanding Good Average Below Average N/A
Friendly and caring service
Outstanding Good Average Below Average N/A
Ability to understand your needs
Outstanding Good Average Below Average N/A
Understandable answers to your questions
Outstanding Good Average Below Average N/A
Professionalism and knowledge of staff
Outstanding Good Average Below Average N/A
Problem solving ability
Outstanding Good Average Below Average N/A
Speed of service
Outstanding Good Average Below Average N/A
Frequency of contacts
Outstanding Good Average Below Average N/A
Offer suggestions
Outstanding Good Average Below Average N/A
Timely issuance of policies
Outstanding Good Average Below Average N/A
Accuracy of policies and documents
Outstanding Good Average Below Average N/A
Accuracy of invoices
Outstanding Good Average Below Average N/A
Convenient office hours
Outstanding Good Average Below Average N/A
Ease of doing business
Outstanding Good Average Below Average N/A
Are there any suggestions that you may have to assist us in improving our service?



How would you like us to contact you?
Please enter appropriate information below: (address, phone, fax, email)



 

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