BELFOR Property Restoration

Customer Satisfaction Report Card
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First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Name of Insurance Company
 

50 characters left.

Job Number (if known)
 

50 characters left.

Property Address (if different than above)
 

50 characters left.

How would you rate our overall performance?
 Poor Below Average Average Above Average Excellent 
Initial Response Time
Ability To Meet Deadlines
Quality Of Our Work
How Effectively We Communicate
Performance Of Our Employees
Knowledge Of Our Employees
Appearance Of Our Employees
Courtesy Of Our Employees
Contribution To Your Recovery
Overall Service You Received

How did you hear about BELFOR?
Insurance Company
Internet
Yellow Pages
Advertising
Friend/Relative
Saw BELFOR Trucks and Vans
Other  

If we did exceed your expectations, would you tell us one thing we did to accomplish this?
 

350 characters left.

Would you recommended BELFOR to others?
Yes
No

How can we improve our service?
 

350 characters left.

May we use you as a reference?
Yes
No

Would you like more information about our RED ALERT Priority Response Program? 
Yes
No