Welcome to the Terrible Herbst Customer Satisfaction Survey. We value your candid feedback and appreciate you taking the time to complete our survey.

Please enter the following information from your survey invitation.

Store #:

Invoice #:

Date: -- 010203040506070809101112 / -- 01020304050607080910111213141516171819202122232425262728293031 / -- 20202021

Time: -- 010203040506070809101112 : -- 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859   -- AMPM

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