Client Survey Form

info@pcstriad.com

Professional Carpet Systems

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What people are saying!!

NEW CLIENT SPECIAL OFFER

MONTHLY SPECIALS

Join the PCS Team

Help us accomplish our mission by giving us just 60 seconds of your time, and in return we will enter you into our monthly client survey contest to win a night out on us.

Dear Friend and Client,

Thank you for using our service. We want to know how we are doing in your eyes. Please let us know if you were thrilled, simply satisfied, or disappointed. This information will help us accomplish our mission which is: To provide our clients with the most outstanding service experience possible!

Directions: After each question please check the number corresponding to the answer that best reflects your opinion. Check N/A if not sure or not applicable.

The personal information section is optional, but if you want to be entered into the monthly drawing we will need this information to contact you if you are selected as the winner.

How satisfied are you with the following aspects of your service experience?

On Time Arrival

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

Courteous on the job site

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

Quality of job

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

Responsiveness to your special requests

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

Telephone courtesy

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

Responsiveness of office staff

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

Schedule availability

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

Amount of information offered

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

Overall Performance

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

Our Reputation

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

Our experience

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

Our guarantee

1 Very Dissatisfied

2 Somewhat Dissatisfied

3 Satisfied

4 Very Satisfied

5 Extremely Satisfied

N/A

After using our service, how likely are you to use us again?

1 Very Unlikely

2 Somewhat Unlikely

3 Likely

4 Very Likely

5 Extremely Likely

After using Professional Carpet Systems, how likely are you to refer someone to us?

1 Very Unlikely

2 Somewhat Unlikely

3 Likely

4 Very Likely

5 Extremely Likely

Are you aware of the Professional Carpet Systems Referral Program?

Yes

What did you like MOST about Professional Carpet Systems?

What did you like LEAST about Professional Carpet Systems?

Additional Comments

Name:

Phone:

Email Address:

Pick three Restaurants you would like to receive a gift certificate from if you?re our winner:

May we use your testimonial for promotional purposes?

Yes

Professional Carpet Systems 351 Forum Pkwy Rural Hall, NC 27045
ph. 336-969-2400 Winston Salem /294- fx. 336-969-2841