All Phase Collision Center

Required fields marked with " * ".

Customer Last Name*:

Date Vehicle Completed:

Job #*:

1. Did the quality of the paint refinish meet your expectations?
Yes   No
Please explain:

2. Did the quality of the body repairs meet your expectations?
Yes   No
Please explain:

3. Were you treated in a freindly, professional and helpful manner?
10   9   8   7   6   5   4   3   2   1
(10 - Excellent; 1 - Poor)
Please explain:

4. Would you recommend this repair facility to your friends and family?
Yes   No
Please explain:

5. Did the time it took to complete the repairs match your expectations?
Yes   No
Please explain:

6. How did you learn about this repair facility? (check all that apply)
Repeat Customer
Insurance Claims Office
Insurance Agent
Family/Friend
Website
Shop Location/Signage
Yellow Pages
Print Ad
Radio/TV Ad
Billboard
Company Brochure
Other:

7. Compliments/Questions/Suggestions for improvement or comments about our employees:

8. Would you recommend the insurance company that paid for the repair?
Yes   No
Please explain:

9. If you have an insurance agent, would you recommend him/her?
Yes   No
Please explain: