Customer Satisfaction Template Survey

1. Please rank the following FPH&A attributes.

	Well Below Average	Below Average	Average	Above Average	Well Above Average
Response Time	*Please rank the following FPH&A attributes. Response Time Well Below Average	Response Time Below Average	Response Time Average	Response Time Above Average	Response Time Well Above Average
Base of Knowledge	Base of Knowledge Well Below Average	Base of Knowledge Below Average	Base of Knowledge Average	Base of Knowledge Above Average	Base of Knowledge Well Above Average
Problem Solving	Problem Solving Well Below Average	Problem Solving Below Average	Problem Solving Average	Problem Solving Above Average	Problem Solving Well Above Average
Efficiency	Efficiency Well Below Average	Efficiency Below Average	Efficiency Average	Efficiency Above Average	Efficiency Well Above Average
Understanding of Customer's Needs	Understanding of Customer's Needs Well Below Average	Understanding of Customer's Needs Below Average	Understanding of Customer's Needs Average	Understanding of Customer's Needs Above Average	Understanding of Customer's Needs Well Above Average

Other (please specify)

2. In what areas do you think FPH&A excels?

In what areas do you think FPH&A excels?

3. What could we be doing better?

What could we be doing better?

4. In choosing to be an FPH&A client, please rank the importance of the following factors. (1 being least important, 5 being the most important.

	1	2	3	4	5
Price	*In choosing to be an FPH&A client, please rank the importance of the following factors. (1 being least important, 5 being the most important. Price 1	Price 2	Price 3	Price 4	Price 5
Reputation	Reputation 1	Reputation 2	Reputation 3	Reputation 4	Reputation 5
Knowledge of Agent	Knowledge of Agent 1	Knowledge of Agent 2	Knowledge of Agent 3	Knowledge of Agent 4	Knowledge of Agent 5
Quality of Coverage	Quality of Coverage 1	Quality of Coverage 2	Quality of Coverage 3	Quality of Coverage 4	Quality of Coverage 5
Choice of Carriers	Choice of Carriers 1	Choice of Carriers 2	Choice of Carriers 3	Choice of Carriers 4	Choice of Carriers 5
Knowledge of Industry	Knowledge of Industry 1	Knowledge of Industry 2	Knowledge of Industry 3	Knowledge of Industry 4	Knowledge of Industry 5
Referral from a friend/ associate	Referral from a friend/ associate 1	Referral from a friend/ associate 2	Referral from a friend/ associate 3	Referral from a friend/ associate 4	Referral from a friend/ associate 5

5. How much do you understand about your current policies?

How much do you understand about your current policies? I understand all of my policies completely.

I understand most of my policies, but have questions.

I understand most of my policies, but do NOT have questions.

I do not want to learn more about my policies.

6. Have you ever recommended FPH&A to others?

Have you ever recommended FPH&A to others? No, I have never recommended you to anyone.

Yes, but only once or twice.

Yes, many times.