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Customer Satisfaction Survey

Dear Valued Customer:

We appreciate having the opportunity to assist with the recent work to your property.
Your overall satisfaction is very important to us, as we pride ourselves on the quality of service offered to our clients.

Kindly take a few moments to fill out the following brief survey honestly and openly. Your contribution will help us improve our overall operations.

Thank you,

*MEMBER COMPANY*

Your Information:

First Name: *This question is required.

Last Name: *This question is required.

Email Address: *This question is required.

Loss Address

Loss City

Loss Province

1. Please let us know which of our DKI member offices serviced you. *This question is required.

2. How did you hear about us?

Please enter an 'other' value for this selection.

Insurance Information

Do you know the name of your Insurance Company?

Insurer:

Who is your insurance broker?

Broker:

Do you know the name of your Adjuster?

Name:

3. Copy of Please rate the services received. *This question is required.

Space Cell	Outstanding	Great	Satisfactory	Fair	Poor
Quality of Service
Communication of staff during project
Timeliness of Service
Friendliness of Staff
Job Cleanliness
Did we perform as well as we said we would?
Overall Rating of Service

4. Did any of our employees in particular provide you with exceptional service?

5. Would you recommend *MEMBER* to others? *This question is required.

6. Please provide us with any additional feedback/comments:

7. Do we have your permission to use this response as a reference in future literature? *This question is required.