Client Satisfaction Survey Form (#13)

Dear Yurek Customer,

We value your opinion and are striving to improve our services to you. Please take a moment to complete the brief survey below, so we may better understand how to meet your needs.

Peter Yurek

Select the stars to rate each of the aspects below:

5=Highest      4=Above Average         3=Average       2= Below Average        1=Unacceptable

Responder Information

Please provide a valid email address to be entered into a draw for a $100.00 gift certificate, along with your full name.