BS and I Network Customer Review Form

BS and I Network Client Review Form

"On the Road, We've Got You Covered'
Thank you for choosing BS and I Roadside Assistance Service. We'd love to hear feedback from our customers. Please fill out the form below:
Date

MonthDayYear
Date
Customer's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityParrish

Postal / Zip Code
Customer's Phone Number
Please enter a valid phone number.
Customer's Email
example@example.com

Satisfaction rating about the product or service

	Very Satisfied	Satisfied	Somewhat Satisfied	Not Satisfied
Quality
Customer service
Experience
Price
Cleanliness
Attitude of the staff
Professionalism of the staff
Friendliness of the staff
Time of Arrival
Was the driver completely equip with necessary tools
Did the driver seems knowledgeable of the service you requested

Did the product met your expectations?

YesNo
Name

First NameLast Name
Brian McGrowder Phone #
If your Service was not upto Standard Expectation please call Mr. McGrowder
What are the things you're satisfied with?
What are the things you're not satisfied with?
Overall rating

1

2

3

4

5

6

7

8

9

10

1 is Worst, 10 is Best
Comments, suggestions, or feedback
Would you refer us to your friends, family, or colleagues?

YesNo
Would you like to receive email newsletter about our products?

YesNo
Please verify that you are human*
Should be Empty:

BS and I Network Client Review Form