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Plan Sponsors: Your opinion is extremely important to us. Please take a moment to fill out this brief survey.

If you have any questions or problems, please email surveys@usicg.com.

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* 1. Name:

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* 2. Organization:

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* 3. Title

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* 4. Email:

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* 5. How did you hear about USI Consulting Group?

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* 6. If you selected referral, please list referral source.

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* 7. What were the factors that led you to choose USI Consulting Group as your provider? (Check all that apply)

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* 8. Please rate your experience with your USI Consulting Group Salesperson/Consultant.

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* 9. Please explain.

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* 10. On occasion, USI Consulting Group holds client seminars. Please list any topics that you would be interested in learning more about.

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* 11. Would you be interested in learning about the additional services we provide?

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* 12. If yes, please check services below.

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* 13. Please list any additional comments here.

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