Service is our business and we take it seriously. Please help us by taking a few minutes to fill out the following form. MicroTech technicians and management would like to know how we can improve upon our performance.


 Mitigation Phase Remediation Phase Restoration Phase Other

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Service Acknowledge

I have reviewed all services and completed by MicroTech, an independent contractor, and certify that all services performed, materials and/or equipment supplied by Microtech in accordance with the signed work authorization have been completed to my satisfaction entirely.

Additional Comments

May we use your comments as a reference to others?
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Customer Information

First Name (required)

Last Name (required)

Phone (required)

Email (required)

Claim # (required)

Address (required)

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Technician(s) Name (Optional) (required)

Date of Service (required)

I authorize this Customer Satisfaction Form

Date (required)

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