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Copyright 2013
Roessner Energy Products,
All Rights Reserved.
Ohio License #24939

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Please complete our customer satisfaction survey.  We would like to have your input on areas that our technicians exceeded your expectations or where they may have fallen short of your expectations.  You only need to fill out the areas that apply to you.  We are committed to customer satisfaction, we need your help by completing this survey to know what areas may need improvement. 
Thank You!

Please share your thoughts with us:

Date of Service:
Customer Name:    
Phone Number:                
Email Address:      

Please select the department this survey is in reference to:

Name of our Employee(s) that helped you whether it be with sales or service:

Ho do you rate the value of our service on a scale of 1 to 5 (1 being the lowest and 5 being the highest)
  1        2        3        4        5

How would rate our Customer Service personnel?
1. Professional
  Poor        Ok        Good        Great
2. Cheerful
   Poor       Ok        Good        Great
3. Knowledgeable
    Poor        Ok        Good        Great

How would rate our service technician?
1. Professional
  Poor        Ok        Good        Great
2. Appearance
   Poor       Ok        Good        Great
3. Knowledgeable
    Poor        Ok        Good        Great
4. Quality
    Poor        Ok        Good        Great
5. Work Area Cleaned Up
    Poor        Ok        Good        Great
6. Did our technician arrive close to the appointment time?
Yes       No
7. If our technician did not arrive close to appointment time, did he contact you beforehand to let you know?
Yes       No

Would you recommend our services to others?
Yes      No

How did you hear about us?
Radio        Yellow Pages        Our Trucks
    Newspaper        Coupons     
Referral - Please provide a name so that we can thank them!
Google        AOL        Yahoo!        MSN     

Additional comments that you would like to add would be greatly appreciated:

Thank you for your time and comments, it is greatly appreciated!  We are committed to continually improving our company with your help.  Thank you again!