Jim Lewis Tire

First Name

Last Name

E-mail Address

Phone

Visit Date

From which staff member did you receive service?

When you entered our store, were you greeted courteously? Yes No

Do you feel our staff listened to your needs or concerns? Yes No

Was your vehicle ready when promised? Yes No

Were you given a thorough explanation of the work performed? Yes No

If additional work was recommended, was it clearly explained? Yes No

Was your vehicle free of problems when returned to you? Yes No

If no, please explain

Based on this experience, what is your overall rating of Jim Lewis Tire & Wheel? Fantastic!
Good
Average
Poor
The worst!

Based on this experience, how likely are you to recommend Jim Lewis Tire & Wheel to a friend, family member or work associate? High likely
Likely
Unlikely
Very unlikely

What is the main reason you chose Jim Lewis Tire & Wheel? Repeat customer
Reputation
Recommended by someone
Coupon or other advertisement
Proximity to my home or office

How did you first learn about Jim Lewis Tire & Wheel? Driving by
Friend or relative
TV or Radio
Internet search
Yellow Pages
Newspaper

How clean did you find our showroom and waiting area? Very clean
Clean
Neither clean nor dirty
Dirty
Very dirty

How clean did you find our restrooms? Not applicable
Very clean
Clean
Neither clean nor dirty
Dirty
Very dirty

Additional comments or suggestions for services you would like us to offer

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Jim Lewis Tire & Wheel does not sell, rent or lease its customer lists to third parties. We will not supply your personal details (e.g. email address, mailing address, phone number) to third parties without your express permission.