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Please tell us your experience with New Image Auto Glass:
Your name:
Service Received:
Glass Replacement
Chip Repair
Window Tint
How was your experience?:
Excellent
Good
Fair
Poor
How likely are you to recommend Auto Glass to a friend or colleague? (On a scale of 0-10, with 10 being extremely likely to recommend and 0 being not at all likely to recommend.)
Not at all Likely 0
1
2
3
4
5
6
7
8
9
10
Extremely Likely
How satisfied are you with the technician's performance in servicing your vehicle? (On a scale of 0-10, with 10 being extremely satisfied and 0 being extremely dissatisfied.)
Extremely dissatisfied 0
1
2
3
4
5
6
7
8
9
10
Extremely satisfied
Please tell us about your experience with New Image:
Your e-mail:
Your phone:
Employee Worked With:
DAVE
DAVID
DOUG
DREW
JACKIE
JOSEPH
KALEB
KIRK
LISA
MAXWELL
RAPHAEL
Insurance Company Name:
It's OK To Use My Comments in Marketing Materials
Yes
No
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