SURVEY: BRAKEmax Customer Survey

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Welcome to the BRAKEmax Customer Survey

*Which BRAKEmax location did you most recently visit?
Choose one of the following answers

4545 N 1st Ave. (First Ave between Wetmore & River)
991 N Pantano Rd (Pantano Rd South of Speedway in Fry's Center)
10529 N Oracle Rd (Oro Valley Target Center)
6560 N Thornydale Rd (Thorydale & Costco Drive)
2240 N Silverbell Rd (Silverbell South of Grant Rd)
2756 S Kolb Rd (Kolb Rd South of Golf links in Fry's Center)
6055 W Jenna Nicole Lane (Cortaro Rd West of I-10)
3245 N Swan Rd (Camp Lowell & Swan in Basha's Center)
7613 N Oracle Rd (Oracle Rd South of Magee in Sprouts Center)
15330 N Oracle Rd (Oracle Rd North of Golder Ranch Rd in Catalina)
7525 S Houghton Rd (Houghton South of Valancia Near Rita Ranch)
1698 W Valencia Rd (Valencia West of I-19 in Walmart Center)

*On a scale of 0-10 how likely are you to refer BRAKEmax to a friend?
Choose one of the following answers

0-Extremely Un-likely
1
2
3
4
5-Neither Likely or Un-likely
6
7
8
9
10-Extremely Likely

*How did you find out about BRAKEmax
Choose one of the following answers

Newspaper Ad
Flyer In Mail
Television Ad
Radio Ad
Yellow Pages Ad
Internet Ad or Search
Referral from friend/Colleague
Other (please specify)

Please enter your comment here:

*How would you rate your service at BRAKEmax today?
Check any that apply

Outstanding
Above Average
Satisfactory
Unsatisfactory

Add any additional comments here:

*Would you like someone from BRAKEmax Customer Service to contact you?

If you want someone from BRAKEmax Customer Service to contact you, please fill in your contact information below

First Name
Last Name
E-mail Address
Contact Phone #
Alternate Phone #
Other
Other
Prefered method of contact
Best time to contact

A note on privacy.
This survey is anonymous. The record kept of your survey responses does not contain any
identifying information about you unless a specific question in the survey has asked for this.