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Please tell us what you think about our web site, company, products, or services. If you provide us with your contact information, we will be able to reach you in case we have any questions.

Customer Satisfaction Survey
What is the Product or Service you wish to evaluate? *
Overall, how would you rate the product? *
 Very good 
 Good  
 Neutral 
 Bad 
 Very Bad 
How long have you used our product? *
 Less than a month 
 3-6 months 
 1-3 years 
 More than 3 years 
 Never used 
 Cannot remember 
 Other 
When did we install the product?

MM 		/
DD 		/
YYYY
How often do you use our product or service? *
 Daily 
 Once a week 
 2-3 times a month 
 Once a month 
 Less than once a month 
 Never 
Would you recommend our product or service to other people? *
 Definitely 
 Probably 
 Not Sure 
 Probably Not 
 Definitely Not 

Additional Information (Optional)
The more you can tell us the better we will become.

What was your favorite thing about the product or Service?
What was your least favorite thing about the product or Service?
Enter an email address if you want a reply.
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Last modified: 08 April 2012