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The Gates BLACK & WHITE sale- no gimmicks, just genuine savings.
Service/Repair Visit Follow Up
Please complete the following form and one of our representatives will contact you.
Fields marked in bold are mandatory.
Personal Information
First Name Registration Number:
Last Name E-mail Address
Daytime Phone Number   Evening Phone Number  
Delivery Date:
Additional Information
1. Would you say that you are completely satisfied with the
overall experience of your recent service visit? 		Yes   No
2. Was all the work completed first time? Yes   No
3. Will you continue to use Gates for future servicing? Definitely would   Definitely would not
4. Would you be able to recommend Gates
as a place to have a vehicle serviced? 		Definitely would   Definitely would not
5. Your next service is due in 12 months; can we
schedule an appointment for you? 		Yes   No
6. In accordance with the Data Protection Act, may we ask for your permission for Gates to contact you again in the future by telephone, post or e-mail (please indicate)? Telephone   Post   E-mail   No Contact
If you have any comments you would
like to add, please do so here:
Please indicate if you wish to subscribe to our e-mail updates: Yes   No reset