How are we doing?

First name:

Last name:

E-mail address:

Date you visited our shop:

Invoice #:


1. When you visited our shop, were you greeted promptly?
Yes   No

2. Did our staff listen to your needs and concerns?
Yes   No

3. Was your vehicle ready when it was promised?
Yes   No

4. Were you given an explanation of the work we performed?
Yes   No

5. If additional work was recommended, was it clearly explained?
Yes   No

6. Based on your experience, how likely are you to recommend us?
Very likely  Likely  Unlikely  Very unlikely

7. What is the main reason you chose us for this visit?
Repeat customer  Reputation  Recommended by someone
Coupon or other advertisement  Close to my home or office

8. How did you first hear about us?
Driving by  Recommended by someone  Internet search
Phone book  Newspaper  Other advertising 

9. How did you find our waiting area?
Very clean  Clean  Dirty  Very dirty

10. How did you find our restrooms?
Very clean  Clean  Dirty  Very dirty

11. Additional comments or suggestions:


  

Name: 

Phone: 

Select a date: 

Select a time:  8AM - 9AM 9AM - 10AM 10AM - 11AM 11AM - Noon Noon - 1PM 1PM - 2 PM 2PM - 3PM 3PM - 4PM 4PM - 5PM

Message: