Continuous Improvement Survey

At Adam's, we are always trying to improve as part of our Constant And Never-Ending Improvement (CANI) program, and your input can help us. We tabulate the data and read all comments. Thank you for taking the time to make Adam's better.

Invoice # or Acct #
Name
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On a scale of 1-10, how likely are you to refer Adam's? *	----12345678910
How can we improve our service?
Please type the letters and numbers shown in the image.