Product & Customer Service Assessment

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Agency Name*

Rank

Name*

First Last

Agency Address

Agency Phone

Agency Email*

Customer Satisfaction

Overall experience with your distributor.

Would you purchase with Slate Solutions again?

Yes

Fit of product

Quality of product

Comfort of product

How satisfied are you with the delivery of our products?

How satisfied are you with the service you received?

How would you rate the response time of your distributor?

Poor	Fair	Good	Excellent

May we contact you to learn more about the answers provided?

Yes

Please provide areas in which we can improve

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