Name: Address: City: Email: Telephone: Type of Service: Triple Play: How would you rate this service Excellent Good Average Poor Terrible Were your monthly charges billed as initially described? Yes No Broad Band Internet How would you rate this service Excellent Good Average Poor Terrible Were your monthly charges billed as initially described? Yes No Dial-Up Internet How would you rate this service Excellent Good Average Poor Terrible Were your monthly charges billed as initially described? Yes No FIOs TV How would you rate this service Excellent Good Average Poor Terrible Were your monthly charges billed as initially described? Yes No Home Telephone How would you rate this service Excellent Good Average Poor Terrible Were your monthly charges billed as initially described? Yes No Cell Phone How would you rate this service Excellent Good Average Poor Terrible Were your monthly charges billed as initially described? Yes No Please Provide Your Comments: