Statement of Satisfaction and Completion | Authorization to Pay | Quality Assurance Form | Back to Quality Assurance Page Sample Quality Assurance Form Customer Name:________________________________________ Adjuster Name:_________________________________________ Agent Name:___________________________________________ How would you rate 1st Action Services' sensitivity to your needs? Excellent            Good            Fair            Poor How would you rate 1st Action Services' response to your loss? Excellent            Good            Fair            Poor How would you rate the arrival time to your home? Excellent            Good            Fair            Poor How would you rate the performance of the staff that came to your home? Excellent            Good            Fair            Poor How would you rate the staff's professionalism? Excellent            Good            Fair            Poor How would you rate the staff's appearance? Excellent            Good            Fair            Poor How would you rate the courtesy of the office staff? Excellent            Good            Fair            Poor Would you recommend 1st Action Services to family and friends? Excellent            Good            Fair            Poor How would you rate 1st Action Services' overall performance? Excellent            Good            Fair            Poor Do you have any suggestions that could help us better serve our future clients? _____________________________________________________ _____________________________________________________ _____________________________________________________ Company Profile | Professional Services | Customer Care | Quality Assurance Program | Photo Gallery | Our Guarantee | Industry Resources | Contact Us | Links | Home 1st Action Services Copyright © 2000. All rights reserved. Developed by Compass Marketing Group