HERO Customer Survey Question Title * 1. What was the Name or Operator Number of the Highway Emergency Response Operator (HERO) that helped you? Question Title * 2. What was the date you received assistance from the HERO? Date / Time Date Time AM/PM - AM PM Question Title * 3. On what roadway did the HERO assist you? IH 20 SH 191 Question Title * 4. What is your home zip code? Question Title * 5. For what reason(s) did you need assistance? Please mark all that apply. Flat Tire Out of Fuel Overheating Dead Battery Mechanical Problem(s) Crash Needed directions Emergency fluids Disabled in traffic Disabled on shoulder Needed a tow Other (please specify) Question Title * 6. How did the HERO know you needed assistance? HERO saw me I dialed 911 Another motorist called it in I don't know I called it in I called HERO 877-699-HERO Other (please specify) Question Title * 7. How long did you wait for assistance? Less than 10 minutes 10-20 minutes 20-30 minutes 30-45 minutes 45-60 minutes Over 60 minutes Question Title * 8. Was the HERO courteous? Yes No Question Title * 9. How do you rate the knowledge of your HERO? Extremely familiar Very familiar Somewhat familiar Not so familiar Not at all familiar Question Title * 10. How do you rate the safety practices of your HERO? Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied Question Title * 11. (Optional) Contact Information. We'd love to know how to contact you if you're available for it! Name Company Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 12. What was your overall impression of your HERO? Extremely valuable Very valuable Somewhat valuable Not so valuable Not at all valuable Question Title * 13. Additional Remarks Done
