February 23, 2012
WHO WE ARE
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LIFE INSURANCE
HEALTH & LIFE QUOTE
FAQ's
HEALTH INSURANCE
ASSURANT HEALTH SHORT TERM MEDICAL QUOTE
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RETIREMENT PLANS
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TELL US WHAT YOU THINK
CLAIMS REPORTING
How Are We Doing?
Your opinion is as important to us as your business. Please take a few minutes to tell us how to make our service to you better.
Please Check One Box For Each
Convenient Office Hours:
Excellent
Fair
Poor
Convenient Office Location:
Excellent
Fair
Poor
Polite Telephone Response:
Excellent
Fair
Poor
Prompt Phone Call Return:
Excellent
Fair
Poor
Insurance Coverage Selection:
Excellent
Fair
Poor
Prompt Policy Delivery:
Excellent
Fair
Poor
Competitive Price Structure:
Excellent
Fair
Poor
Easy-To-Read Documentation:
Excellent
Fair
Poor
Professional Sales People:
Excellent
Fair
Poor
Responsive Customer Service:
Excellent
Fair
Poor
Frequent Enough Contact:
Excellent
Fair
Poor
Prompt Claim Response:
Excellent
Fair
Poor
Professional Claim Handling:
Excellent
Fair
Poor
Fast, Fair Claim Settlement:
Excellent
Fair
Poor
For the following, please check "YES" or "NO"
Should additional services be made available?
YES
NO
If "YES", please explain:
Should additional products be made available?
YES
NO
If "YES", please explain:
Should our service days or hours be extended?
YES
NO
If "YES", please explain:
Was the web-site informative and easy to use?
YES
NO
If "NO", please explain:
For the following, please tell us:
What you MOST LIKE about doing business with Russell & Schrader:
What you LEAST LIKE about doing business with Russell & Schrader:
The MOST IMPORTANT IMPROVEMENT you would like us to make:
Please Tell Us Who You Are:
Name:
Address:
City:
State:
Zip:
Phone:
Email Address:
* = Required Field
Thank you very much for taking the time to tell us about our agency.
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