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Customer Survey
Conserv Rep
2019-06-17T20:38:10+00:00
THANK YOU IN ADVANCE FOR PROVIDING FEEDBACK ON YOUR CONSERV EXPERIENCE
Which Location Did You Visit?
*
Please Select...
Napa, Ca
Moorpark, Ca
Santa Barbara, Ca
Lancaster, Ca
Los Angeles, Ca
Riverside, Ca
Buellton, Ca
Santa Paula, Ca
Santa Maria, Ca (Stowell Rd)
Santa Maria, Ca (Betteravia Rd)
San Luis Obispo, Ca (Broad St)
San Luis Obispo, Ca (Santa Rosa St)
Valencia, Ca
Pacific Palisadies, Ca
Road Forks, NM
Santa Clarita (Copper Hill Rd)
Fontana
What Did You Purchase?
*
Fuel
Propane
Car Wash
Coffee
Freal
Snacks
Beverage
Beer/Wine
Lottery
Tobacco
Ice
Other
Which of the Following Words Best Describe This Location?
*
Friendly
Great Prices
Good Prices
Fair Prices
Overpriced
Clean
Dirty
Unfriendly
Fast
Slow
How Well Does This Location Meet Your Needs?
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Please Select...
5 Extremely Well
4 Very Well
3 Somewhat Well
2 Not So Well
1 Not At All Well
How Likely Are You To Purchase From Us Again?
*
Please Select...
5 Extremely Likely
4 Very Likely
3 Somewhat Likely
2 Not So Likely
1 Not At All Likely
How Likely Would You Recommend Conserv Fuel to a Friend/Colleague?
*
Please Select...
5 Very Likely
4 Likely
3 Maybe
2 Not Likely
1 Not At All
Overall, How Satisfied Are You With Conserv Fuel?
*
Please Select...
5 Extremely Satisfied
4 Satisfied
3 Neutral
2 Unsatisfied
1 Extremely Unsatisfied
How Long Have You Been A Customer of Conserv Fuel?
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Please Select...
My First Purchase
Less Than 6 Months
6 Months to 1 Year
1 - 2 Years
3+ Years
No Purchase Yet
Additional Comments, Questions or Concerns?
0 / 500
Would You Like To Be Contacted?
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No
Yes
Name
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Email Address
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Phone Number
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