Thank you for selecting Complete Auto Glass™ for your recent Auto Glass service. Our goal is to provide fast, friendly service at a competitive price. We work hard to ensure that your experience with our company is a positive one.

Please take a moment to fill out the customer feedback form below. We appreciate any comments you may have.

Please keep us in mind for all your future auto glass repair or replacement needs. It was a pleasure working with you!

Please rate us on a scale of 1 - 5 (1 meaning not satisfied and 5 meaning completely satisfied)……

1-Not Satisfied
2-Somewhat Satisfied
3-Satisfied
4-Very Satisfied
5-Completely Satisfied

Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied	Completely Satisfied
1. Were we friendly and knowledgeable on the phone?
1	2	3	4	5
2. Was your appointment scheduled at a convenient time?
1	2	3	4	5
3. Was our technician punctual?
1	2	3	4	5
4. Did our technician answer all of your questions?
1	2	3	4	5
5. Was your vehicle vacuumed to your satisfaction?
1	2	3	4	5
6. Would you recommend our company to others?
1	2	3	4	5
	If not, please explain...
7. Please rate your overall satisfaction with our company.
1	2	3	4	5
8. How did you find out about us?
Web Page    Phone Book    Word of Mouth    Other
9. Additional Comments:
Full Name
Date of service		(mm/dd/yy)