Form Survey Test

1. Name

First

Last

2. Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email

Phone

3. Are you satisfied or dissatisfied with the information provided by SER Contractor within the Residents Information Booklet?

Suggestion/Comment

4. Are you satisfied or dissatisfied with the information provided by SER Contractor about works in and around your home?

Suggestion/Comment

5. Are you satisfied or dissatisfied with the way SER Contractor dealt with any problem or issue you reported?

Suggestion/Comment

6. Did WE keep to the agreed time for appointments made?

7. Thinking about SER Contractor, how would you rate them in terms of the following?

	Very Unsatisfied	Unsatisfied	Neutral	Satisfied	Very Satisfied
Were WE - Polite	Very UnsatisfiedWere WE - Polite Very Unsatisfied	UnsatisfiedWere WE - Polite Unsatisfied	NeutralWere WE - Polite Neutral	SatisfiedWere WE - Polite Satisfied	Very SatisfiedWere WE - Polite Very Satisfied
Were WE - Helpful	Very UnsatisfiedWere WE - Helpful Very Unsatisfied	UnsatisfiedWere WE - Helpful Unsatisfied	NeutralWere WE - Helpful Neutral	SatisfiedWere WE - Helpful Satisfied	Very SatisfiedWere WE - Helpful Very Satisfied
Were WE wearing identifiable company clothing and ID badge	Very UnsatisfiedWere WE wearing identifiable company clothing and ID badge Very Unsatisfied	UnsatisfiedWere WE wearing identifiable company clothing and ID badge Unsatisfied	NeutralWere WE wearing identifiable company clothing and ID badge Neutral	SatisfiedWere WE wearing identifiable company clothing and ID badge Satisfied	Very SatisfiedWere WE wearing identifiable company clothing and ID badge Very Satisfied

8. Are you satisfied or dissatisfied with the quality of finished work? PLEASE PROVIDE COMMENT:

Suggestion/Comment

9. Overall, are you satisfied or dissatisfied with the works carried out in and around your home?

	Very Unlikely	Unlikely	Neutral	Likely	Very Likely
	Very UnlikelyVery Unlikely	UnlikelyUnlikely	NeutralNeutral	LikelyLikely	Very LikelyVery Likely

Your Experience

Overall, how would you rate your experience with us?

10. Do you have any further comments you would like to make which may help to improve the service? PLEASE PROVIDE COMMENT: