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* 1. Customer or Business Name

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* 2. Date Service Completed

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* 3. Are you a new or returning client?

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* 4. If new, what made you choose Burkett?

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* 5. Which location did you use?

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* 8. How was your experience overall?

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* 9. How well did we meet your needs?

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* 10. Will you use Burkett for future services?

T