CLIENT QUESTIONNAIRE

Client Questionnaire Use this form to send your questionnaire by email, or print it out and mail it to us at the addresses above. 1. When you made your first call to us, were you satisfied with the way your call was handled? Yes No 2. Were you always treated courteously on the telephone when you called? Yes No 3. Were your telephone calls returned promptly? Yes No 3a. Were you courteously treated by staff working on your file? Yes No 4. In what kind of case did we represent you? 5. Do you feel that we moved your case along as quickly as possible? Yes No 6. How long was the case from first contact with us to its conclusion? 7. Would you use our firm again if you had another legal problem? Please give us your comments. Yes No 8. Would you recommend our firm to a friend, relative or business associate who needed a lawyer? Please give us your comments. Yes No May we use your comments in 7 and 8 as testimonial in our newsletter and website? Yes No 9. Please rate how you feel about the overall quality of the legal services you received. Excellent Good Adequate Fair Poor 10. Do you feel that our fees were reasonable and fair based on the nature of your case and the extent and amount of work involved? Yes No 11. Suggest ways in which any of our services might be improved: 12. Suggest additional services that you would like us to provide now or in the future: 13. Check items that you would like to receive from our firm: General brochure describing firm services Lawyer biographical information Copies of the following brochures written by Mr. Vercammen: 1. WHAT TO DO IN AN AUTOMOBILE ACCIDENT. 2. WILLS - Protecting Loved Ones. 3. MUNICIPAL COURT. 4. PERSONAL INJURY CASES. 5. COOPERATING & WORKING WITH YOUR ATTORNEY. 6. EXPUNGEMENT. 7. REAL ESTATE. 8. NEW JERSEY DIVISION OF MOTOR VEHICLE POINTS 9. WORKER'S COMPENSATION 10. STARTING YOUR OWN BUSINESS. 11. PROBATE AND ADMINISTRATION OF AN ESTATE. 12. LIVING WILLS and ADVANCE DIRECTIVES. 13. COMPELLING CAR INSURANCE TO PAY MEDICAL BILLS 14. CAR INSURANCE/ VERBAL THRESHOLD 15. MVC / DMV POINTS. 16. CRIMINAL LAW. 17. POWER OF ATTORNEY. 18. FALL DOWN INJURIES 19. CAR RENTALS 20. FIRM BROCHURE AND INTERNET WEBSITE Other information: Please describe: 14. If you want to receive any of the above brochures from our office, please be sure to fill out the following: Name 15. What is your computer e-mail address: Thank you for your time and help. KENNETH VERCAMMEN & ASSOCIATES, P.C.