Healthy Homes Carpet Care

 

Customer Survey Form
DIRECTIONS: After each question, please write the number corresponding to the answer that best reflects your opinion. Put N/A if not sure or not applicable. 

Very Dissatisfied                              Very Satisfied

1            2            3            4            5

1.     How satisfied are you with the following aspects of Healthy Homes Carpet Care?
a. On time arrival:  
b. Courteous on the jobsite: 
c. Quality of cleaning job: 
d. Responsiveness to your special requests:
e. Responsiveness to problems:  
f. Telephone courtesy:
g. Responsiveness of office staff:
h. Schedule availability:  
i. Amount of information offered: 
j. Overall performance:
k. Payment options:
l. Our reputation: 
m. Our experience: 
n. Our guarantee:

2.     What do you like MOST about Healthy Homes Carpet Care?

3.     What do you like LEAST about Healthy Homes Carpet Care?

4.     After using our service, are you more or less likely to use us again?
More likely:

Less likely:
Comments:

5.     After using Healthy Homes Carpet Care, are you less or more likely to refer someone to us?
More likely:

Less likely:  
Comments:

6.     Are you aware of the Healthy Homes Carpet Care Referral Reward Program?
Yes:

No:  
7.     Additional Comments:

First Name (optional*):
Last Name (optional*):
Telephone number:
May we use your testimonial for promotional purposes?
Yes:

No:  
We read all customer comments. Upon receiving this form, if you have included your name and phone number, we will send your $60.00 certificate.

*(Identification required to receive $60.00 in cleaning)

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