Thrifty White Customer Experience Survey

Question Title

* 1. Name

Question Title

* 2. Store Location

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* 3. To better serve you, please choose the category that best fits your comment or question

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* 4. Comment
Please tell us about your experience. Please do not give personal health information or medication in your comment. This is to protect your privacy.

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* 5. Would you like to be contacted regarding your comment?

Yes

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* 6. If "Yes", please provide contact information.

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 7. Overall Satisfaction

Very satisfied

Satisfied

Neutral

Dissatisfied

Very dissatisfied

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* 8. Wait Time

Very satisfied

Satisfied

Neutral

Dissatisfied

Very dissatisfied

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* 9. Quality of Care

Very satisfied

Satisfied

Neutral

Dissatisfied

Very dissatisfied

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* 10. How likely are you to return?

Very likely

Likely

Neutral

Unlikely

Very unlikely

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* 11. How likely are you to recommend us to your family and friends?

Very likely

Likely

Neutral

Unlikely

Very unlikely

Thrifty White Customer Experience Survey

Question Title

* 1. Name

Question Title

* 2. Store Location

Question Title

* 3. To better serve you, please choose the category that best fits your comment or question

Question Title

* 4. CommentPlease tell us about your experience. Please do not give personal health information or medication in your comment. This is to protect your privacy.

Question Title

* 5. Would you like to be contacted regarding your comment?

Question Title

* 6. If "Yes", please provide contact information.

Question Title

* 7. Overall Satisfaction

Question Title

* 8. Wait Time

Question Title

* 9. Quality of Care

Question Title

* 10. How likely are you to return?

Question Title

* 11. How likely are you to recommend us to your family and friends?

* 4. Comment
Please tell us about your experience. Please do not give personal health information or medication in your comment. This is to protect your privacy.