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* 1. Account #

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* 2. How did you hear about Jody Millard?

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* 3. What service did you most recently receive from Jody Millard?

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* 4. How would you rate your overall experience with Jody Millard?

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* 5. How would you rate the effectiveness of the service you received?

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* 6. How would you rate the level of service you received from our field representatives?

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* 7. How would you rate the level of service you received from our office professionals?

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* 8. I would like to hear more information on the following services:

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* 9. How likely is it that you would recommend Jody Millard? (10 being most likely and 1 being least likely)

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* 10. We want you to be 100% satisfied with our services. Please list any questions or additional comments you have so we can achieve that goal.

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* 11. Do you give Jody Millard permission to use this survey response?

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* 12. Please provide us with your contact information so that we can better assist you in the future.

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