Customer Survey

All fields bold are required.

On a scale of 1-5 please rate your satisfaction with the following aspects of Ideal Insurance Agency.

Pleasant and knowledgeable customer service.
1. Poor 2. Could Be Better 3. Good 4. Great 5. Excellent
Assistance during a claim.
1. Poor 2. Could Be Better 3. Good 4. Great 5. Excellent
Convienient payment plans.
1. Poor 2. Could Be Better 3. Good 4. Great 5. Excellent
Prompt response to requests and questions.
1. Poor 2. Could Be Better 3. Good 4. Great 5. Excellent
Would you recommend Ideal Insurance Agency to a friend or colleague? If yes, may we have a name and contact #
Name:
Phone:
What is the major reason you stay with Ideal Insurance Agency?
What are some things you wish Ideal Insurance Agency would do for you that we are not currently doing?
I wish to remain anonymous.
I am happy to offer my name and any of my comments as possible testimonials.
Name:
Phone:
E-Mail:
Security Code:

Company name