Customer Survey Form

CUSTOMER SATISFACTION SURVEY An asterisk * indicates a required field.
Thank you for taking the time to complete our survey. In appreciation, you will be entered in a quarterly drawing for a $50 gift certificate to the restaurant of your choice. *Only entries from current A+ Imaging Systems customers will be accepted.
Device #*	What's this?
Company Name*
Your Name*
Phone Number*
Email Address
Address*
Address Line 2
City*
State*
Zip*

We want to ensure that we are "making the grade" with your organization. Please grade us in the following areas using "A", "B","C", "D" or "F"ailing.
	1. When you call in for service how would grade the the courtesy of the representative handling your call?
	2. When you order supplies, how would you grade the timely delivery and accuracy of your order?
	3. When you call in for service, how would you grade the promptness of the technician's response?
	4. How would you grade the technician's ability to communicate in a courteous and professional manner?
	5. Overall, how would you grade your satisfaction level with the work performed by your technician?
	6. How would you rate your sales representative's courtesy, professionalism and product knowledge?
	7. How would you rate the accuracy and readability of your invoices?
	8. How would you rate your overall satisfaction with A+ Imaging Systems?
	9. Would you recommend A+ Imaging Systems to others?
10. Do you plan to purchase or lease any of the following in the next 12 months?
	Black and White Copier	Fax
	Color Copier	Network Scanner
	Black and White Printer	Electronic Document Management/StorageSolution
	Color Printer
Additional Comments:

Your device tag is usually located on the front panel
of your copier, printer or fax machine.

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