Air Conditioning & Heating Survey Who was your Tech?*Invoice Number*Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email Was our office staff helpful and courteous?*YesNoN/ADid your Technician treat you as a valued customer?*YesNoN/ADid we arrive during the scheduled time?*YesNoN/ADid the Technician wear protective shoe booties?*YesNoN/ADid the Technician explain how to resolve the problem?*YesNoN/ADid the Technician quote the price before work began?*YesNoN/ARate your impression of the Technicians knowledge and competence*Very dissatisfiedDissatisfiedNeutralSatisfiedVery satisfiedRate the Technicians courtesy and professionalism*Very dissatisfiedDissatisfiedNeutralSatisfiedVery SatisfiedRate our efficiency to resolve the problem and answer your questions*Very dissatisfiedDissatisfiedNeutralSatisfiedVery SatisfiedRate our overall performance*Very DissatisfiedDissatisfiedNeutralSatisfiedVery SatisfiedDoes anyone in your home suffer from allergies to airborne dust, pollen or dander?*YesNoN/ADo you feel your electric bill is excessively high?*YesNoN/ADo you experience uncomfortable temperature swings from room to room?*YesNoN/ADo you experience excess humidity in the winter or summer?*YesNoN/AIs there ever a damp or musty odor in your home?*YesNoN/ADo you feel your system is excessively noisy?*YesNoN/AHow old is your air conditioning unit?*Please select the number of years12345678910111213141516+Please list your comments or concerns:Would you like a free consultation on a new Air conditioning system?*YesNoN/AWould you refer your friends and family to Bill Joplin’s Air Conditioning & Heating?*YesNoN/ANameThis field is for validation purposes and should be left unchanged.