At Bob Clouse Insurance we are committed to satisfying the needs and wants of our customers.  We appreciate your interest in our services and ask you to complete the following questionnaire. 

You may also call us at 916.988.3457 or send us email.

PLEASE NOTE:  All responses to our survey are confidential. 

Questionnaire

1. How did you hear about Bob Clouse Insurance?
Web Email Magazine Newspaper ad From a friend Direct Mail BNI Other
If other, please provide more information.

2. Which Bob Clouse Insurance services have you used?
  Please choose one Automotive Property General Liability Health Life Disability Other   
If other, please provide more information.


3. How would you rate the quality of our services overall?
   Excellent
   Very Good
   Good
   Fair
   Poor
Please include comments below


4. How would you rate the usefulness of our services?
   Excellent
   Very Good
   Good
   Fair
   Poor
Please include comments below


5. How would you rate our responsiveness of our staff to your needs?
   Excellent
   Very Good
   Good
   Fair
   Poor
Please include comments below


6.  Is there any member of our staff you would like to recognize for their services?  If yes, please name the individual below and briefly describe why you have recognized them.

7.  Do you have any suggestions or comments on how we could improve our services?

The following responses are optional, however should you want us to follow-up with you on any of your comments, we ask that you provide the following information.

required field
Email

 I would like a call to discuss my comments.

Thank you for your feedback