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Customer Satisfaction Survey
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How would you rate us?
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Rate 1 out of 5
Rate 2 out of 5
Rate 3 out of 5
Rate 4 out of 5
Rate 5 out of 5
Was your experience positive?
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Yes
No
How can we improve?
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Better service
Friendlier staff
Cleaner facility
No need, everything was great
Would you recommend us?
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Yes
No
How likely are you to recommend us to your friends or family?
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Not at all Likely
Extremely Likely
0
1
2
3
4
5
6
7
8
9
10
Comments or suggestions
Would you like your feedback to remain anonymous?
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Yes, stay anonymous
No, I’ll share contact info
Name
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First
Last
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Email
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