Traffic Wash Customer Satisfaction Survey
Today's Date *

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Name
Prefix
First
Last
Suffix
Phone Number

###		-
###		-
####
Email
Is it okay to contact you?
 Yes 
 No 
 E-mails only 
 Calls only 
Will not contact you without your permission.
Traffic Wash Customer reward card # (optional)
Are you a customer of Traffic Wash? *
 Yes 
 No 
 I am not a customer yet, but i've seen your work. 
If yes. How long have you been our customer?
 Less than a month 
 3-6 months 
 1-2 month(s) 
 More than 2 years 
 Cannot remember 
 6 months to 1 year 
 More than 1 year 
Overall, how would you rate the service?
 Very good 
 Good  
 Neutral 
 Bad 
 Very Bad 
How often do you get our service?
 Daily 
 Once a week 
 Twice a week 
 2-3 times a month 
 Once a month 
 Less than once a month 
 Whenever  
 Never 
Would you recommend our service to other people? *
 Definitely 
 Probably 
 Not Sure 
 Probably Not 
 Definitely Not 

Additional Information (Optional)

What was your favorite thing about the service?
What was your least favorite thing about the service?
Suggestions
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