"
*
" indicates required fields
Step
1
of
6
16%
Email
*
24|7 Home Rescue Refrence Number
What was the main reason you decided to leave?
*
Price/Cost
Quality of Product/Service
Customer Support Issues
Engineering/Technical Issues
Other (please specify in the below box):
Descrption
How satisfied were you with the quality of our product/service?
*
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
How would you rate your experience with our customer support?
*
Excellent
Good
Average
Poor
Did Not Contact Support
Would you consider using our product/service again in the future?
Yes
No
Maybe (If Maybe, Please explain)
If Maybe, Please explain what can we do to regain you as our customer
What could we have done to keep you as a customer?
*
