Salon visited: Select Salon 79 Crossing 94 Crossing Bloomington Plaza Blue Springs Brentwood Pointe Champaign Commons Chouteau Crossing Clarkson/Clayton Center Country Club Plaza Crestwood Decatur Deer Creek Crossing Des Peres Dorsett Village Edwardsville Eureka Towne Center Florissant Plaza Gravois Bluffs Green Street Harvester Hen House Market Place High Ridge Lafayette Center Lake Saint Louis Market Place Monticello Plaza Montvale Commons Raytown Square Richardson Crossing Saint Joseph Saint Louis University Shiloh Southroads Center St Peters Square Swansea Plaza Telegraph Plaza Twin Oaks Warson Woods Washington Crossing Waterloo Commons Wentzville Wildwood Crossing Woods Mill Plaza Zumbehl Commons

Rate the following on a scale from 1 to 5:

5 = Excellent     4 = Good     3 = Fair     2 = Poor     1 = Bad

1. Your overall experience:
    5   4   3   2   1

2. The likelihood you will return to Custom Cuts:
    5   4   3   2   1

3. The likelihood you will refer a friend to Custom Cuts:
    5   4   3   2   1

Additional comments:

What services did you receive?

Stylist:

How often do you visit Custom Cuts?

Same Location? Yes    No

First Name:

Last Name:

Email Address: