| Your name: |
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| On what date? |
January 1, 1970 |
| If making a telephone inquiry, how was the receptionist? |
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| If your appointment was an incall, was the escort's place clean, tidy and comfortable? |
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| How would you rate your escort in terms of appearance and attire? |
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| How would you rate your escort in terms of attitude and service? |
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| Compared to other escorts you may have used, how would you rate your total experience with this escort? |
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| Will you use us again? |
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Comments:
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