AGENCY RATING FORM
On a scale of 1 to 10, with 10 being the highest possible score, how would you rate [Agency Name] on the following items?
| | Professionalism of employees |
| Employees' knowledge of insurance |
| Sending renewals on time |
| Policy accuracy |
| Claims handling |
| Courtesy |
| Billing accuracy |
| Overall rating of service, compared with other agencies that you have dealt with |
| In the space below, please indicate what you like the most about [Agency Name]. |
| In the space below, please indicate what you like least about [Agency Name]. |
| Why do you buy your insurance from [Agency Name]? |
| In your opinion, what makes [Agency Name] different from other agencies? |
| Do you have any suggestions about how we might do things differently to improve the quality of our service? |
Thank you very much for your comments.
How has [Agency Name] treated you? Tell us! Rate us 1 to 5.
5 = Superior
4 = Better than expected
3 = About what expected
2 = Worse than expected
1 = Disappointing
| | Have you been welcomed when you've come to our office? Were we friendly and glad to help? |
| Were we happy after calling our office? |
| Did we listen well? Did you feel that we were concerned about you? |
| Did we meet your needs? Did we do what you wanted us to do? |
| Did we try to give you choices and suggest alternatives? |
| Did we help solve your problems? |
| Did we take enough time with you? did we explain things clearly? |
| Have you received helpful information from: |
| a) newsletters? |
| b) visits or discussions? |
| Did you feel we had the insurance knowledge you were looking for? |
| Did we make it very clear that we appreciate your business? |
We appreciate your candid reply -- and promise to build on our strengths and improve areas you indicate need attention.
Thank you for your trust.
P.S. We especially thank you for the nice things you have said to your friends about [Agency Name] that has encouraged them to come to us.