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We Value Your Feedback
Thank you for being a Pekin customer and for taking the time to share your feedback with us. Your feedback is extremely important and helps us continue to improve our service to you.
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1.
How would you rate your overall satisfaction with Pekin Insurance?
(Required.)
Extremely Satisfied
Mostly Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Mostly Dissatisfied
Extremely Dissatisfied
Extremely Satisfied
Mostly Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Mostly Dissatisfied
Extremely Dissatisfied
2.
Is there specific feedback you would like to share with us today?
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3.
What does your feedback relate to?
(Required.)
Quote
Policy Change
Claim
Billing or Payment
Rates, Discounts, or Fees
Renewal
Documentation
Cancellation
Website
Other (please specify)
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4.
What type of insurance policy does your feedback relate to?
(Required.)
Personal (Auto, Home, RV, etc)
Commercial
Life
Other (please specify)
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5.
To what extent do you agree or disagree with the following statement: "Pekin Insurance makes it easy for me to do business with them."
(Required.)
Strongly Agree
Mostly Agree
Somewhat Agree
Neutral
Somewhat Disagree
Mostly Disagree
Strongly Disagree
Strongly Agree
Mostly Agree
Somewhat Agree
Neutral
Somewhat Disagree
Mostly Disagree
Strongly Disagree
6.
Would you be interested in joining our research panel to help us improve your experience with Pekin Insurance?
Yes
No
7.
Your contact information if you'd like us to follow up with you or if you would like to join our research panel:
Name
Email Address
