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 About You

First Name:		Last Name:
Address:		City:
State:		Zip:
Phone Number:		eMail Address:

 About Your Service:

Your Job Number or Date of Service:
What was your service related to?		Plumbing Heating A/C
Did our Technician arrive when expected?		Yes No
Was the job completed to your satisfaction and expectations?		Great OK Poor
Did our Technician communicate the services performed, the associated charges ad answer all your questions?		Great OK Poor
Was our Technician courteous and did he treat your home with respect?		Great OK Poor
Did our Technician clean up the work area properly?		Great OK Poor
Was our office staff helpfull and courteous?		Great OK Poor
What is the chance that you would recommend RPB, Inc. to a friend or relative?		Great OK Poor
Please rate your overall experience with RPB, Inc.?		Great OK Poor

 Comments

Is there any questions or unresolved issues you may have where you would like us to call you?		Yes No
Do you have any comments, concerns or suggestions about your latest experience with RPB, Inc. that you would like to share with us?
Do you give us permission to use your comments\testimonial for future advertising?		Yes No