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Feedback Form: Service
Contact Name:
(required)
Business Name:
(required)
Equipment ID:
(if applicable)
Phone Number:
(required)
E-Mail Address:
(optional)
Question
Answer/Rating
Please Rate Accordingly:
excellent
5
very good
4
good
3
fair
2
poor
1
doesn't apply
0
Promptness of response time:
(rate)
Appearance of technician:
(rate)
Your satisfaction with machine performance upon completion of the service call:
(rate)
Please rate the attitude of your technician:
(rate)
Please rate the technicians communication and interaction with your office staff:
(rate)
Comments
Please provide any additional comments.
