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* 1. How long have you been a customer of our company?

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* 2. How would you rate your experience with your sales representative?

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* 3. How responsive has our company been to your questions or concerns?

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* 4. How would you rate the quality of your equipment installation?

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* 5. How would you rate the efficiency of your equipment installation?

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* 6. How well did our customer service representative answer your question or solve your problem?

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* 7. How would you rate your experience with our customer service representative or counter staff?

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* 8. How would you rate the parts availability at our company?

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* 9. How would you rate the quality and availability of parts and service support?

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* 10. Which of the following words would you use to describe our products? Select all that apply.

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* 11. Overall, how satisfied or dissatisfied are you with our company?

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* 12. How likely are you to purchase any of our products or services in the future?

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* 13. How likely is it that you would recommend our company to a friend or colleague?

Not at all likely
Extremely likely

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* 14. If you selected an answer of extremely poor or extremely well to any of the questions above, please help us understand why you selected that answer by providing a few comments:

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* 15. Do you have any other comments, questions, or concerns? 

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* 16. Please fill out your contact information if you would like to receive a coupon for your next purchase

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