The Business Catalog
Would love to know…
How was your experience with them?
How was your experience with us?
Very Negative
Somewhat Negative
Indifferent
How was your experience with us?
Positive
Very Positive
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Would you like them to contact you about your experience?
Yes
No
If no, all information will be collected anonymously
Name
First
Last
Phone
Email
How satisfied were you with the overall service?
5 - Completely Satisfied
4
3 - Indifferent
2
1 - Not satisfied at all
Tell us more
Please leave a Contact Name and Phone Number/Email Address if you would like them to contact you to discuss your feedback further
Would you recommend their small business?
Yes
No
Would you use their products or services again?
Yes
No
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