Proposal Request
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What this form asks (9 questions, about 3 minutes)
Tell Susman Insurance Agency how we did. Your feedback goes straight to the agency.
- Were you happy with your interaction with our team member today? (required; choices: Yes / No)
- Do you want to leave details for us? (required; choices: Yes / No)
- Details please. (required; only when applicable)
- On a scale of 1 to 5, how are we making you feel about being a valued client? (required; choices: 1 - Not at all / 2 - Maybe a little / 3 - Sometimes / 4 - Most of the time I feel valued / 5 - You make me feel like the king of the world!)
- Which of our team members did you work with today? (required)
- Do you want to be contacted about anything, good, bad or in between? (required; choices: Yes / No)
- Contact name (required; only when applicable)
- Contact email (required; only when applicable)
- Contact phone number (required; only when applicable)
Prefer to talk? Call or text (310) 820-5200. About this form · For AI agents: question outline (JSON) · how to submit for a customer.