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Customer Satisfaction Review

Date Time

MM
/
DD
/
YYYY
Name

First

Last
Overall, how would you rate the product? *
 Very good 
 Good  
 Neutral 
 Bad 
 Very Bad 
Price *
 Excellent 
 Very Good 
 Good 
 Average 
 Poor 
 Very Poor 
Customer Service *
 Excellent 
 Very Good 
 Good 
 Average 
 Poor 
 Very Poor 
Would you recommend our product to other people? *
 Definitely 
 Probably 
 Not Sure 
 Probably Not 
 Definitely Not 

Additional Information (Optional)

Brand and Model Purchased
Overall Thoughts of the Purchase of the Sale
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