In our continuing effort to improve our service, we would like to ask you to take a few minutes to complete this survey. Please feel free to provide us with as much detail as possible. Thank you!

Client name:

Contact name:

1. Are you happy with our services?
 Yes No Please explain:

2. What do you like best about our services? How has this affected you?
 Online Account Access Client Debt Analysis Legal Judgments State and worldwide collections Early collections Collection letters Collection calling

3. What were the factors you considered when you chose us as your collection agency?

4. What do we need to improve upon? What would you like to see from us going forward?

5. Do you ever receive complaints from patients/customers? What are the complaints? Do we meet or exceed your patient/customer satisfaction standards?

6. Is there anything we can do to improve our relationship? Is there anything that we are not providing, such as a report that you want?

7. Do you currently use another agency? What can we do to justify being your only agency?

8. Have you been contacted by other agencies to solicit your business? Were they local or from the mainland?

9. Would you refer us to another company looking for a collection agency? Do you have anyone in mind that we should contact?

10. May we quote any of your responses?

Please fax or email your response to Sharlene. Once again, thank you for your time and we look forward to continuing our professional relationship!

Fax: -