<%@ LANGUAGE="VBSCRIPT"%> Sears & Associates, Inc.
How Are We Doing?

Your comments are always welcome. To assist us in our efforts to provide you with the best possible insurance services, we would appreciate you taking the time to answer these questions. They are designed to bring areas of concern to our attention, as well as let us know what we are doing right. Fields marked with * are required.

Additional comments are certainly welcome!

Thank you!


Note: This information is not being transmitted over a secure server. Feel free to contact our agency if you have any questions.

Name (optional):

* E-Mail Address:


(We ask for your e-mail address only for the purpose of transmitting this survey to our office)

Please select a button on the scale indicating the strength of your answer:


Do we treat you courteously and respectfully?

Always Sometimes Neutral Rarely Never

Do we see you promptly for your scheduled meetings?

Do we spend enough time with you?

Do we explain your insurance policies adequately?
When we see you in the office, are we familiar with your insurance history?
Do we answer your questions and explain things clearly?
Can you call us anytime and not feel guilty about it?
Do we maintain a clean, comfortable, and professional-looking office?
Is adequate parking available?
Do we answer the telephone promptly?
Do we assist you in filling out insurance forms?
Do we discuss financial arrangements and other personal matters with you privately?
Please describe the three things you like most about our office:
Please describe the three things you like least about our office:
Do you have any comments or suggestions that might help us improve our services?

Sears & Associates, Inc.