Essig Service Partner Plan Cancellation Form
Thank you for using our service. To help us understand why you decided to cancel, please provide us with feedback by filling in the information below.
Thank you for the opportunity to serve you.
*
First Name
*
Last Name
*
Street Address
Address Line 2
*
City
*
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
*
Zip Code
*
Phone Number
*
Email Address
May I email you back?
How long have you been a service partner?
Less than 1 month
1-3 months
3-6 months
6-12 months
1-2 years
2-5 years
More then 5 years
Not required but appreciated!
Please briefly explain why you are canceling.
Not required but appreciated!
What could we have done differently that would have kept you from canceling?
Not required but appreciated!
Do you plan on replacing this service with a similar service provided by a different company, or discontinuing this service altogether?
Switching to another company
Discontinuing altogether
Not required but appreciated!
Please rate the following aspects of our service. (not required but appreciated)
Very Good
Good
Neutral
Bad
Very Bad
Customer Service Reps
Technician's Knowledge
Ease of Use
Price
Quality Of Service
Speed of Service
Not required but appreciated!
Compared to other services of this type, how would you rate our service?
Much Better
Better
Same
Worse
Much Worse
Don't Know
Not required but appreciated!
Overall, how satisfied were you with our service?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Not required but appreciated!
Overall, how easy was the cancellation process?
Very Easy
Easy
Neutral
Difficult
Very Difficult
Not required but appreciated!
Would you recommend this service to others?
Yes
No
Not required but appreciated!
Will you continue to use Essig for your service needs in the future?
Yes
No
*
Indicates Response Required