Statewide Wrecker Service Customer Survey

Customer Service Representative:
Was Your Call Answered Promptly? . . .	Make a Selection Excellent Good Fair Poor
Rate the Courtesy of the Call Taker: . . .	Make a Selection Excellent Good Fair Poor
Rate the Knowledge/Ability of the Call Taker: . . .	Make a Selection Excellent Good Fair Poor
Rate the Overall Service of the Call Taker: . . .	Make a Selection Excellent Good Fair Poor
What was the Name of the Call Taker? . . .
Wrecker Driver:
Rate the Overall Appearance of the Driver: . . .	Make a Selection Excellent Good Fair Poor
Rate the Overall Appearance of the Wrecker: . . .	Make a Selection Excellent Good Fair Poor
Rate the Courtesy of the Driver: . . .	Make a Selection Excellent Good Fair Poor
Rate the Driver's Ability to Assist You: . . .	Make a Selection Excellent Good Fair Poor
Rate the Professionalism of the Driver: . . .	Make a Selection Excellent Good Fair Poor
Rate the Overall Service of the Driver: . . .	Make a Selection Excellent Good Fair Poor
What was the Name of the Wrecker Driver? . . .
What was the Number of the Truck? . . .
Wrecker Service:
Overall Service Satisfaction:	Make a Selection Excellent Good Fair Poor
How Quickly Help Arrived:	Make a Selection < 30 Minutes 31 - 45 Minutes 46 - 60 Minutes 61 - 90 Minutes Over 90 Minutes Left Before Help Arrived Help Failed to Arrive
Did this Timeframe Meet Your Expectations?	Yes         No
Would You like a Follow-up Call Regarding Your Service?	Yes         No
Date and Time of Service: January February March April May June July August September October November December       1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31       2009 2010 2011 2012       Time:
Name:
Phone:
Reference #:
Comments:
Security Device: Enter Code from Security Device: