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Customer Survey


  * Required Fields
Name (Optional):
* Account Name:
Position:
Function:
Region:
Industry:
 Location (City, State):
 * E-Mail :
How did you hear about Pure Aqua

How important are the following areas to your business?
Please answer using the rating scale where
5 means "extremely important" and 1 means "not important at all"
Our understanding of your business needs
Our ability to provide solutions to your problems
The representative(s) assigned to your account
The response from the PURE AQUA Customer Care Center
Value for the price
PURE AQUA performance against your expectations
Delivery of high quality products
Delivery of the products when you want it
My PURE AQUA representative(s) knows his/her products and their proper application
How satisfied are you with PURE AQUA in the following areas?
Please answer using the rating scale where
5 means "extremely satisfied" and 1 means "very unsatisfied"
Our understanding of your business needs
Our ability to provide solutions to your problems
The representative(s) assigned to your account
The response from the PURE AQUA Customer Care Center
Value for the price
PURE AQUA performance against your expectations
Delivery of high quality products
Delivery of the products when you want it
Our use of the time we spend at your facility
My PURE AQUA representative(s) knows his/her products and their proper application
Please give us your response to the following questions
How long have you used PURE AQUA for your water and/or process treatment needs ?
What are the expected savings you would like to see from your water treatment supplier(s)?
What are the expected savings you realize today working with your water treatment supplier(s)?
What does PURE AQUA DO that most impacts your business?
What does PURE AQUA NOT DO that most impacts your business?
What supplier(s) do you currently use for your water treatment needs?
Are you considering to switch suppliers? Yes      No
Would you like a PURE AQUA representative to contact you? Yes      No
Is there anything you would like to tell PURE AQUA that was not already asked in the survey?
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