To help us better serve our customers, let us know how we are doing.

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* 1. Your Information

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* 2. Company Information

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* 3. Are you a current Chem-Aqua customer?

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* 4. Who is your Chem-Aqua Representative?

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* 5. Please rate the overall quality of your Chem-Aqua Representative.

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* 6. On a scale of 1 to 10, would you recommend Chem-Aqua to friends or colleagues?

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* 7. Overall, when you deal with Chem-Aqua, categorize the order of importance 1-5 with 1 being most important and 5 being least important.

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* 8. Do you currently use Chem-Aqua SMARTLink Delivery Service for hands-free chemical delivery?

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* 9. Please rate the overall quality of your Chem-Aqua SMARTLink Driver.

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* 10. Did our products or services meet your expectations?

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* 11. Do you follow us on social media? (Please choose all that apply)

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* 12. Would you like to provide additional comments or feedback?

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* 13. Would you like to be contacted regarding your Chem-Aqua experience?

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