Feed Back Form

Your Name
Invoice Number	Input invoice number found on your receipt or the system serial number on the back of your new computer. (located on white sticker)
Email Email is a cost effective way for me to communicate with my customers. May I contact you by email regarding specials or seminars?	Email? Yes No Email Address Retype your email here
Feedback Section
Rate overall value of services received
Work Done Was job complete and functioning the way you expected Professionalism Was I courteous, Dressed appropriately, Act Properly Communication Did I communicate the work being done, billing and follow up as you expected? Price Did you pay a fair value for the services you received?	Work Done Poor Fair Good Great! Professionalism Poor Fair Good Great! Communication Poor Fair Good Great! Price Ouch! Fair Good Great!
How can I improve (Please give me a brief description of what I can do to improve my products or services.)
What new service or product would you like me to offer?	What creative way could I serve You better?
Referral/Email Information
Do you know of a business that could use the services I provide	Company Name Contact Phone
May I use your feedback in my written or online marketing?	Referrals Yes No