Customer Feedback Form Establishment Name from appointment: Establishment Phone from appointment: Appointment Information Was Contact Name, Establishment Name and address correct? YesNo If not, what was incorrect? Did you leave a price? YesNo Are you following up? YesNo Why or why not are you following up? Did you close the deal? YesNo Refused Appointment? YesNo Explain: Additional Comments: If a replacement is being requested, it will only be considered if within 24 hours of the day of the appointment. No exceptions will be made.