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Customer Service Evaluation

Thank you - Customer service is very important to us. We appreciate your time in filling out the information below to let us know how we are doing.

Please Rate Your Experience...

1. How Courteous was your Telephone Service Representative?
Poor	Below Avg	Good	Above Avg	Excellent

2. Did the Scheduling Options Meet your Needs?
Yes	No

3. How Courteous was your Glass America Service Technician
Poor	Below Avg	Good	Above Avg	Excellent

4. Did the Glass America Service Technician inform you of your safe drive away time?
Yes	No

5. Please Rate the Quality of Work Performed
Poor	Below Avg	Good	Above Avg	Excellent

6. Please Rate your Overall Service Experience
Poor	Below Avg	Good	Above Avg	Excellent

7. How did you Find Us?
Referred	Yellow Pages	Repeat Customer	Internet	Other:

8. Would you Recommend Glass America?
Yes	No

9. Comments:

First Name:	*	Last Name:	*
Phone:		E-mail:	*
Service Date:		Store Location :	*
Insurance Co:		Agent:

			*Glass America respects your privacy and will not sell, rent, share or otherwise disclose any information provided.