Secured by SSL

Client Service Survey


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Personal Information
First Name
Required
Last Name
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
E-Mail Address
Required
Rate Your Client Service Manager
1 = Poor, 5 = Outstanding
Select the person you are evaluating
Optional
Timely response to phone calls or e-mails
Optional
Attitude
Optional
Knowledge of insurance products
Optional
Availability
Optional
Ability to address your needs promptly
Optional
Comments about Client Service Manager
Optional
Rate Our Agency Service...
1 = Poor, 5 = Outstanding
Ability to access our staff
Optional
Ability to address your needs promptly
Optional
Business hours (8:30am to 5:00pm)
Optional
Ease of doing business with us
Optional
Phone system
Optional
Comments about our agency services
Optional
Other Items
What do you LIKE about our agency?
Optional
What do you DISLIKE about our agency?
Optional
How can we improve our service?
Optional
Submission Validation
Required
CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 
Enter the Validation Code from above.
Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
Save on Auto Insurance
Auto Quote Home Quote Life Quote Business QuoteAuto, Home, Life, Business

Automobile Insurance Homeowners Insurance
Service Center Partners Program Refer A Friend Get A Quote
 
Home About Service Center Resources ContactGet A Quote
Boer Insurance Group | 2535 Five Mile Road NE, Grand Rapids, MI 49525 | Ph: 616-363-7766 | Fx: 616-363-6626
Facebook LinkedIn Blog RSS Feed