We are very interested in the quality of service you received during our visit.  Please take a few moments to fill out our survey. Thank you.

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*Name:    

*Email:     

Address:  

City:        

State:      

Zip:         

Phone:    

May we use your name as a reference?

How well did we...
1=poor and 5=excellent


Schedule your appointment at your convenience?*

Arrive at the time we promised?*

Listen to you?*

How would you rate?
1=poor and 5=excellent


Overall performance of office?*

Overall performance of salesman?*

Overall performance of installer?*

Why did you decide to buy from us?*

What brought you to Burkholder's HVAC?*

Would you be interested in a service and/or maintenance agreement?

Questions or Comments:



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