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THE EGIS GROUP Agency Survey
Help Us Provide the Best Service Possible!
One Simple 5 Question Form - takes only a minute...Thank you!


Please provide the following information:

Your Name:
Street Address:
City:
State:
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
Please State the Kind of Situation You Had:
(was this regarding a claim, policy service, etc.)
Question 1:
How would you rate our courtesy and friendliness?
Excellent Good Fair Poor
Question 2:
How would you rate our representative's understanding and explanation of your situation?
Excellent Good Fair Poor
Question 3:
How would you rate the final outcome or resolution of your situation?
Excellent Good Fair Poor
Question 4:
How would you rate our professionalism and timeliness?
Excellent Good Fair Poor
Question 5:
Did You Know our agency provides many other insurance and investment services?

(To find out more, please put a check by the line of coverage you are interested in at right, and we will contact you!)

Yes, I Did!    No, I did not.

Annuities Disability Income
Estate Planning Financial Planning
I.R.A.'s Life Insurance
Mutual Funds Retirement Planning
401K/403B Plans Employee Benefits
Group Medical Group Life
Disability Plans Profit Sharing
Compensation Plans Other (in comments)
Any Final Comments?
(If so please list them here!)
Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!

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