Disaster Repair Service Survey Form
Please complete the Disaster Repair Service Survey Form to help us improve our services. Your feedback is valuable and will be kept confidential.
Your Name (optional)
First Name
Last Name
What type of disaster repair did you receive?
*
Please Select
Flood
Fire
Storm
Earthquake
Other
When was the service completed?
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How did you request the repair service?
*
Phone
Online Portal
In Person
Other
Please rate the following aspects of our repair service.
*
Rows
Poor
Fair
Good
Excellent
Quality of Repairs
1
2
3
4
Timeliness
5
6
7
8
Professionalism
9
10
11
12
Communication
13
14
15
16
How satisfied are you with the overall disaster repair service?
*
1
2
3
4
5
Was your property restored to your expectations?
*
Yes
Partially
No
Would you recommend our disaster repair service to others?
*
Yes
No
What could we do to improve our disaster repair service?
Any additional comments or feedback?
Submit Survey
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