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* 1. Name

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* 2. Email

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* 3. Phone Number

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* 4. Postal Code

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* 5. Date of visit

Date

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* 7. How was the customer service you experienced? With 1 being poor and 10 excellent please rank your experience.

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* 8. How long was your wait time? With 1 being poor and 10 excellent please rank your wait time.

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* 9. We would love any other feedback good or bad.

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