Survey Questionnaire

Survey Questionnaire Form

Please fill out the following information for our records. Your input is valuable to us.

Name

Please enter your full name including middle name if applicable.

    Email

    Please enter your email address.

      Phone number

        Age

          • Under 18

          • 25-34

          • 35-44

          • 45-54

          • 55-64

          • 65 or older

          Gender

            • Male

            • Female

            How often do you use our services?

              • Daily

              • Weekly

              • Monthly

              • Rarely

              What do you value most about our services?

                • Quality

                • Customer service

                • Price

                • Variety

                What improvements would you suggest?

                  Would you recommend our services to others?

                  Please check the box below to proceed

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                    Thank you for taking the time to complete this survey!

                    Your insights are invaluable and will help us serve you better.

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