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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your cell phone number?

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* 4. When is the best time to call?

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* 5. What is your preferred e-mail address?

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* 6. How many years (roughly) have you been insured with Nationwide?

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* 7. Have you had an insurance claim in the last few months?

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* 8. Overall, were you satisfied or dissatisfied with the claims process?

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* 9. How did you report your claim?

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