Customer Care Feedback Form v 2.0

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Customer Care Ticket #
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What is your name?* This field is required.
First Name
Last Name
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What is your email address?* This field is required.
example@example.com
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What is your phone number?* This field is required.
Please enter a valid phone number.
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Which store would you like to provide feedback on?* This field is required.
Alhambra - 151 N Garfield Ave
Anaheim - 2429 W Ball Road
Artesia - 12154 Artesia Blvd
Campbell - 330 E Hamilton Ave
Carrollton - 2540 Old Denton Road Ste 116
Cerritos - 20226 Pioneer Blvd
Chino Hills - 13920 City Center Drive Ste 4015
Chino Hills - 15911 Pomona Rincon Road Ste 100
Costa Mesa - 3033 Bristol St Ste L
Covina - 845 W Cypress Ave
Cupertino - 11111 Wolfe Road
Cypress - 9111 Valley View St Ste B
Downey - 8901 Apollo Way 4A
Duluth - 4020 Satellite Blvd Suite 118
El Monte - 11968 Garvey Ave
Fountain Valley - 9475 Warner Avenue
Fountain Valley - 10065 Garfield Ave
Fountain Valley - 16225 Harbor Blvd
Frisco - 9292 Warren Parkway
Fullerton - 505 N State College Blvd
Garden Grove - 9786 Westminster Avenue
Garden Grove - 13481 E Euclid Ste B
Garden Grove - 12002 Harbor Blvd
Grand Prairie - 2609 W Pioneer Pkwy #100
Houston - 9798 Bellaire Blvd Ste B
Houston - 3825 Richmond Ave
Houston - 8910 Westheimer Road
Huntington Beach - 7225 Edinger Ave Ste J
Irvine - 14845 Jeffrey Road
Irvine - 2730 Alton Parkway, Ste 100
Las Vegas - 3959 Spring Mountain Road
Las Vegas - 7795 S Rainbow Road Ste 100
Las Vegas - 6255 South Durango Dr
Montebello - 2200 W Beverly Blvd
Riverside - 1201 University Ave Ste 101
Rowland Heights - 1627 Fullerton Road
San Jose - 1743 Berryessa Road
San Jose - 375 Saratoga Ave
Santa Ana - 1700 East McFadden Ave
Torrance - 18547 S Western Avenue
Tustin - 13771 Newport Ave Ste 12
Westminster - 15491 Brookhurst St
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What type of feedback would you like to share with us?* This field is required.
Customer service
Product quality
Order accuracy
Store environment
Mobile app
Hiring/employee
Other
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Based upon your feedback, what would you rate us?* This field is required.
1
2
3
4
5
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What is the specific issue with the app?
Missing Leaves
User account problems
App interface
Payment issue
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Comments you would like to share.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
10
Take a picture of your receipt
11
Mobile ID #* This field is required.8 digit ID number located under your Profile
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Would you like us to contact you directly about this?
YESNO
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Was the feedback addressed?
Yes
No
Pending
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Department assigned to address feedback.
Operations
Marketing
Human Resources
IT
Facilities
Franchise
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Feedback submitted via channel.
Web
Yelp
Google
LoyaltyPlant
Social media
Other
Should be Empty: