* 1. Name:

* 2. Company:

* 3. Address:

* 4. Address2:

* 5. City/Town:

* 6. State:

* 7. Zip Code:

* 8. Phone:

* 9. Email:

* 10. Parts or Service Invoice # (Please enter your invoice number below)

* 11. How Well Did We Serve You?

  Excellent Good Fair Poor
Helpful attitude of parts/service personnel
Parts and/or Service work correct the 1st time
Answered my questions
Shows appreciation for my business
(Service Dept Only) Communicates estimate & quote changes as appropriate
Parts and/or Truck ready when promised
Overall satisfaction with this transaction
Overall satisfaction with Mid-State Truck

* 12. Based on your experience, would you recommend our company to a friend?

* 13. What can we do to serve you better?

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