First Name*

Last Name*

Address Line 1

Address Line 2

City

State--State--District of ColumbiaMarylandVirginia

Zip/Postal Code

Date Installed

Did our Sales Representative explain the features of the products?YesNo

Did our Sales Representative explain the installation procedure to your satisfaction? YesNo

Did the installation schedule meet your requirements? YesNo

When our crew arrived, did they go over the installation process with you? YesNo

At the completion of the job, did our technician explain the systems operation to you?YesNo

Would you recommend Climatic to someone you know?YesNo

PLEASE CHECK ONE

Sales Staff

CourtesyExcellentGoodFairPoor

Personal AppearanceExcellentGoodFairPoor

Product KnowledgeExcellentGoodFairPoor

Communication SkillsExcellentGoodFairPoor

ProfessionalismExcellentGoodFairPoor

Follow-throughExcellentGoodFairPoor

Presentation MaterialsExcellentGoodFairPoor

Overall PerformanceExcellentGoodFairPoor

Installation Crew

CourtesyExcellentGoodFairPoor

Personal AppearanceExcellentGoodFairPoor

Product/Job KnowledgeExcellentGoodFairPoor

Communication SkillsExcellentGoodFairPoor

ProfessionalismExcellentGoodFairPoor

Care of your PropertyExcellentGoodFairPoor

Appearance of TruckExcellentGoodFairPoor

Overall PerformanceExcellentGoodFairPoor

How many other companies did you contact before calling Climatic?--Number--onetwothreefourfivesix

Which ones?

Why did you choose Climatic?

Would you be interested in any of our other products or services now, or in the future?Service AgreementAir ConditionerFurnaceDuct CleaningAir CleanerUltra Violet LightHeat PumpHumidifierProgrammable Thermostat

Do you know someone who might be interested in our products or would simply like some information?

Name

Phone

Name

Phone

May we use you as a reference? YesNo

Do you have any suggestions on how we may better serve you in the future?

Would you like to receive correspondence in the future via email?YesNo

Email Address:*