Sample Customer Satisfaction SurveyPlease rate the speed of service you received during this visit:Strongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly DisagreeOverall, please rate the quality of service that you received during this visit-Select-Very GoodGoodNeutralPoorVery PoorDid you have any questions or concerns while you were visiting the Store?YesNoWere your questions or concerns addressed to your satisfaction while you were visiting the Store?YesNoWould you like a representative from the Store contact you regarding your concern?YesNoIf in the question above you indicated that you would like to be contacted by a representative of the Store, please provide your preferred telephone number below. Area Code - Phone Number SubmitReset