Don's Mobile Glass -Customer Survey

1. Please Rate the Following:

1. Dear Valued Customer: Thank you for giving Don's Mobile Glass the opportunity to serve you. We are committed to providing you with superior service and we are constantly striving to improve our services therefore, your comments are a valuable resource. Any rating other than "very good" or "exceptional" means that we have not done a good enough job. Thank you very much for your time, we hope to be working with you on your next project!

Don Monaco, Founder

Please rate the following:

	Poor	Fair	Good	Very Good	Exceptional
Completion of work when promised	*Dear Valued Customer: Thank you for giving Don's Mobile Glass the opportunity to serve you. We are committed to providing you with superior service and we are constantly striving to improve our services therefore, your comments are a valuable resource. Any rating other than "very good" or "exceptional" means that we have not done a good enough job. Thank you very much for your time, we hope to be working with you on your next project! Don Monaco, Founder Please rate the following: Completion of work when promised Poor	Completion of work when promised Fair	Completion of work when promised Good	Completion of work when promised Very Good	Completion of work when promised Exceptional
Quality of work performed	Quality of work performed Poor	Quality of work performed Fair	Quality of work performed Good	Quality of work performed Very Good	Quality of work performed Exceptional
Professionalism of glass installer	Professionalism of glass installer Poor	Professionalism of glass installer Fair	Professionalism of glass installer Good	Professionalism of glass installer Very Good	Professionalism of glass installer Exceptional
Professionalism of customer service representative	Professionalism of customer service representative Poor	Professionalism of customer service representative Fair	Professionalism of customer service representative Good	Professionalism of customer service representative Very Good	Professionalism of customer service representative Exceptional
Clean-up	Clean-up Poor	Clean-up Fair	Clean-up Good	Clean-up Very Good	Clean-up Exceptional
Overall satisfaction	Overall satisfaction Poor	Overall satisfaction Fair	Overall satisfaction Good	Overall satisfaction Very Good	Overall satisfaction Exceptional

2. Work Order Number:

Work Order Number:

3. Customer Name:

Customer Name:

4. Phone number:

Phone number:

5. What City was the work performed in:

What City was the work performed in:

6. Email Address:

Email Address:

7. Type of Work:

Type of Work:

8. Insurance Agent Name:

Insurance Agent Name:

9. Installer Name:

Installer Name:

10. CSR Name:

CSR Name:

11. How did you hear about Don's Mobile Glass?

How did you hear about Don's Mobile Glass? Prior Customer

Website Search

Newspaper

Yellow Pages

Insurance Agent/Company

Vehicles

Word of Mouth/Referral

Mailer

Other

12. If you selected "OTHER" please tell us how you heard about us?

If you selected "OTHER" please tell us how you heard about us?

13. On a scale of 1 to 10 - where 10 means "extremely likely" and 1 means "not at all likely", how likely is it that you would recommend DMG to a friend or colleague?

	10	9	8	7	6	5	4	3	2	1
Extremely Likely	*On a scale of 1 to 10 - where 10 means "extremely likely" and 1 means "not at all likely", how likely is it that you would recommend DMG to a friend or colleague? Extremely Likely 10	Extremely Likely 9	Extremely Likely 8	Extremely Likely 7	Extremely Likely 6	Extremely Likely 5	Extremely Likely 4	Extremely Likely 3	Extremely Likely 2	Extremely Likely 1

14. Testimonial/Comments:

Testimonial/Comments:

15. May we use your testimonial and/or comments in our promotional and marketing material?

May we use your testimonial and/or comments in our promotional and marketing material? Yes

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