Silver Star Plumbing

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Your Name*	Phone Number	E-mail Address*
Technician's Name	Date of Service	Time of Service
Was the technician courteous? Yes No
What stood out the most about our tech?
Did he address all of your concerns and answer all of your questions? Yes No
Did he wear shoe covers and clean up everything after finishing the job? Yes No
How was our response time?
Did he share with you our diamond club membership? Yes No
If only an estimate... Why?
What would you change about our service to better serve you?

Phone Representative was	Pleasant	Courteous	Discourteous
Work Performed was	Excellent	Good	Fair
Employee's Appearance	Neat	Clean	Needs Improvement
Employee's Attitude	Pleasant	Courteous	Discourteous
Service Charge was	Less than expected	About Right	More than expected
Would use us again	Yes	Maybe	No
How you found us:	TV Ad	Newspaper Ad	Repeat Customer
	Radio Ad	Yellow Pages	Referral
	Coupons	Trucks	Magnet
	Billboard	Direct Mailer	Search Engine
Additional Remarks
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