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About You...

First Name (*)

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Last Name (*)

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Address (*)

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City (*)

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State

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Zip (*)

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Phone Number (*)

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Email Address (*)

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Email Confirm (*)

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Purpose of Visit...

Which of the following best describes the purpose of our visit? (*)



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Your Experience...

1) Promptness of our personnel... (*)





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2) Professional appearance (personal, vehicles, etc.)... (*)





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3) Courtesy and friendliness... (*)





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4) Took time to understand my needs... (*)





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5) Knowledgeable... (*)





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6) Kept my home neat and clean... (*)





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7) Explained the operation and maintenance of my system... (*)





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8) Explained equipment and labor warranties... (*)





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9) Completed the work in a timely manner... (*)





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10) Resolved all issues to my satisfaction... (*)





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11) Overall Satisfaction... (*)





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Likelihood to Recommend...

12) How likely are you to recommend Palm Coast Heating & Air Conditioning to a friend or colleague? (*)





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13) Are you interested in a service and / or a maintenance agreement? (*)




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Please share any additional comments or describe in your own words your overall experience (for example, what you thought we did exceptionally well, or what could have been better).

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Friends and Family


If you know someone who could benefit from our services, please indicate their name and phone number below

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Anti-Spam

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