Customer Service Survey We Would Like Your Help! Customer service is very important to us. Please help us by taking time to fill out this brief questionnaire. * indicates required field Store Location: Date of Store Visit: Time of Store Visit: Morning Afternoon Evening Was the store clean? Yes No Were you greeted by an employee? Yes No Was the product you desired available? Yes No Were sale items clearly marked? Yes No Was the quality of the product satisfactory? Yes No Were your purchases check out quickly? Yes No You chose our store because (you may check more than one): Convenient Location Advertised Items Prescription Department Friendly Service Recommended by a Friend Other (describe in Comments section) Comments or Suggestions: How many times per month do you shop this store? More than 3 3 Times or Less Would you recommend this store to a friend? Yes No May we contact you? Yes No Name: Address: City: State: Zip: Phone #: Email: CAPTCHA Code:* Thank you for your time. We value your opinion, comments and suggestions.