Dr. Flue, Inc. - Inspection

First Name

Last Name

Address

Address Line 2

City

State

Zip Code

E-Mail Address

Phone Number

Work Performed:
Sweep Inspection Liner Stove Install Other:

	Excellent	Good	Fair	Poor
Overall Quality of Work

Value of Work Completed

Technician's Neatness / Cleanliness

Courtesy of Technician

Courtesy of Office Personnel

Respect Shown for your Home

Would you be interested in a Service Agreement?	Yes	No
Would you call our company again?	Yes	No

Comments

Referrals of those in need of our services:
Name	Phone Number

Name	Phone Number

Access Code

First Ticket #

Last Ticket # (if more than one)

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