Date Date Format: MM slash DD slash YYYY Ref IDName* First Last Primary Email* Customer ExperienceWe would like to know how we are doing so far. Please let us know how your last transaction was handled by our team.Who handled your latest transaction with our office?* Elaine Jeff Kim Megan Rudy Can't Remember How was your service/quote handled?*Over the PhoneThrough EmailBoth Phone and EmailIn OfficeVideo or Web MeetingFRIENDLINESS:*UnacceptableCould have been betterGoodVery GoodExceptionalPROFESSIONALISM:*UnacceptableCould have been betterGoodVery GoodExceptionalKNOWLEDGE OF PRODUCTS:*UnacceptableCould have been betterGoodVery GoodExceptionalEXPLANATION OF CHOICES:*UnacceptableCould have been betterGoodVery GoodExceptionalWhat could we have done to improve?We love true and honest feedback. Feel free to suggest ideas on how we can improve. If you would like to recognize one of our team members for AWESOME service, we love to hear that to!PreferencesYour preferred communication preference:*There are many ways you can communicate with our office. From the list below, please identify your PREFERRED method of communication. You are free to select more than one if applicable. Call Cell Call Office DO NOT CALL Call Home Text DO NOT TEXT Email Online Chat DO NOT EMAIL Video Web Meeting USPO DO NOT SEND VIDEO Best Time to ContactOf the choices below, please select the best time to call.Any TimeEarly MorningMorningLunchtimeEarly AfternoonLate AfternoonYour Customer Service DesiresFrom the choices below, what is most important to you?*The Cheapest PriceCompetitive PriceQuality Insurance CompanyMultiple Product OfferingHaving the right coverageProfessional ServiceExplanation of Coverage OptionsTrustFriendliness of Support StaffMultiple Communication Choices (Phone, Text, Chat)Office LocationFrom the choices below, what is NEXT MOST important to you?*The Cheapest PriceCompetitive PriceQuality Insurance CompanyMultiple Product OfferingHaving the right coverageProfessional ServiceExplanation of Coverage OptionsTrustFriendliness of Support StaffMultiple Communication Choices (Phone, Text, Chat)Office LocationPersonalized Policy and Discount Review*How often would you like us to offer you personalized policy and discount reviews?Annual OfferEvery 2 - 3 YearsEvery 3 YearsEvery 5 YearsOnly When Requested by YouConcernsFrom the choices below, which could be considered a concern or interest you may have?Select all that apply. Accumulation of Wealth Protecting Wealth Against Lawsuits Loss of Income Due to Death or Disability Evaluating Life Insurance Needs for Loved Ones Maximizing Tax Reduction Strategies College Funding for Children College Funding for Grandchildren Proper Distribution of Wealth to Heirs or Charity Upon Death Rising Health Insurance Costs Informative Videos:From time-to-time (and very seldom), we like to send our clients personalized videos using a link to our client portal. Please let us know if you would like this extra service. Only remove the check box if you DO NOT wish to receive our very infrequent message. Your selection can be changed at any time. To see our client portal CLICK HERE Explanation of Coverage Options Birthday Message New Rate or Product Notifications Emergency Alert Notification If there is anything else you would like us to know, please indicate here. Customer service is the provision of service to customers before, during and after a purchase. Customer service concerns the priority an organization assigns to customer service relative to components such as product innovation and pricing.