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Exit Survey
 
 
Name/Company/Address/Phone/Fax/Email
   
 
 
 
Do you have a "walk-in" establishment?
 
Yes
 
No
 
 
 
Is your location a residence?
 
Yes
 
No
 
 
 
What was your last year's gross revenue?
   
 
 
 
What is your projected revenue in the current year?
   
 
 
 
How long have you been in business?
   
 
 
 
Do you advertise and if so what are your methods?
   
 
 
 
Do you have a 'specialty' within your industry?
   
 
 
 
Do you maintain a website and if so, what is the address?