CUSTOMER FEEDBACK FORM

Please use this form to give us your suggestions, compliments or complaints. They’re important to us.

Customer FeedBack

DATE OF SERVICE:(Required)

Month

Day

Year

APPROX TIME:(Required)

Hours

Minutes

AM/PM

TYPE OF FEEDBACK:(Required)

Suggestion

Compliment

Complaint

ABOUT THIS SERVICE:(Required)

Customer Service

Technician

Service on Dishmachine

Product

Install

Other

HOW OR WHY WAS SERVICE PROVIDED?(Required)

Scheduled by Phone

Scheduled through the Website

Preventative Maintenance (Pre Scheduled)

Service Call Request

Other

ARE YOU:(Required)

Existing Customer

Other

WOULD YOU LIKE A FOLLOW-UP CALL?(Required)

CONTACT ME TO RESOLVE MY ISSUES:

First Name

MY PHONE:

COMPANY NAME:

PROVIDE ADDITIONAL DETAILS HERE:

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This field is for validation purposes and should be left unchanged.

About Us

Established in 1980, Summit Supply caters to the restaurant, hospitality and institutional trades, specializing in warewashing, on-premise laundry, cleaning and paper products.

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SERVING NORTHERN NEW ENGLAND SINCE 1980 | 603.679.1222

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