B.J. KILPATRICK, INC
Leading the Industry in Excellence since 1968
Customer Satisfaction and Feedback Form
Company Name: 
Date of Service Call:
Date of Service Call: When did the technician arrive?
How would you describe his overall appearance?
How would you describe his demeanor?
Did the technician resolve the issue?
Did the technician work efficiently?
Was your service call answered in a friendly manner?
Was your bill for service easy to read and accurate?
Please provide additional comments:
