First State Bank Customer Service Survey

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* 1. Which location did you visit today?

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* 2. What type of service did we provide today? (Please select all that apply)

Transaction

Account Opening

Product/Service Information

Loan Related Service

Other

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* 3. Were our employees friendly and helpful?

	1	2	3	4	5	6	7	8	9	10
(0=Highly Dissatisfied and 10=Highly Satisfied)	(0=Highly Dissatisfied and 10=Highly Satisfied) 1	(0=Highly Dissatisfied and 10=Highly Satisfied) 2	(0=Highly Dissatisfied and 10=Highly Satisfied) 3	(0=Highly Dissatisfied and 10=Highly Satisfied) 4	(0=Highly Dissatisfied and 10=Highly Satisfied) 5	(0=Highly Dissatisfied and 10=Highly Satisfied) 6	(0=Highly Dissatisfied and 10=Highly Satisfied) 7	(0=Highly Dissatisfied and 10=Highly Satisfied) 8	(0=Highly Dissatisfied and 10=Highly Satisfied) 9	(0=Highly Dissatisfied and 10=Highly Satisfied) 10

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* 4. Based on your visit how satisfied were you overall?

	1	2	3	4	5	6	7	8	9	10
(0=Highly Dissatisfied and 10=Highly Satisfied)	(0=Highly Dissatisfied and 10=Highly Satisfied) 1	(0=Highly Dissatisfied and 10=Highly Satisfied) 2	(0=Highly Dissatisfied and 10=Highly Satisfied) 3	(0=Highly Dissatisfied and 10=Highly Satisfied) 4	(0=Highly Dissatisfied and 10=Highly Satisfied) 5	(0=Highly Dissatisfied and 10=Highly Satisfied) 6	(0=Highly Dissatisfied and 10=Highly Satisfied) 7	(0=Highly Dissatisfied and 10=Highly Satisfied) 8	(0=Highly Dissatisfied and 10=Highly Satisfied) 9	(0=Highly Dissatisfied and 10=Highly Satisfied) 10

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* 5. Did one certain team member go out of their way to help you that you would like to recognize?
If so, please explain:

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* 6. Did you have any issues with your visit to our location that you would like to further discuss?
If so, please explain and provide contact information:

Thank you for helping us provide the best service to our customers.
We appreciate your business!