Satisfaction Survey Email First Name * Last Name * Phone * Receive Text? * Yes No Email * Confirm Email * Address 1 Address 2 City State Zip Code Date of Service * Customer Satisfaction Survey Form Was our technician on time for the service appointment? Yes No Were you satisfied with the work that was done at your appointment? 5 = Very Satisfied 4 3 2 1 = Very Dissatisfied Did the technician answer all of the questions and explain in detail what was done? 5 = Very Satisfied 4 3 2 1 = Very Dissatisfied Did the technician discard extra materials properly without leaving your home a mess? 5 = Very Satisfied 4 3 2 1 = Very Dissatisfied Did our dedicated call staff answer all of your questions and were they helpful? 5 = Very Satisfied 4 3 2 1 = Very Dissatisfied Did the technician repect your home upon entering for service? 5 = Very Satisfied 4 3 2 1 = Very Dissatisfied How would you rate your overall experience? 5 = Very Satisfied 4 3 2 1 = Very Dissatisfied Would you refer your friends and family to our company? 5 = Very Satisfied 4 3 2 1 = Very Dissatisfied Comments Do you have any questions about your past services that were left unresolved? Yes No Please let us know if you have any questions or concerned that we can address with management. Schedule Service Online with Barker's Web Site Full Name * Email Address * Phone * Type of Request* New Equipment Estimate Service/Maintenance Parts Other Are You a New Customer?* Yes No How Can We Help?*
