Instructions: Please fill this Form out on the same day as your visit. Complete the Form by checking the appropriate boxes.
Once received, we will mail you a $12 Gift Card for your efforts. Evaluations can be completed no more than 2x per year (per address). Your Evaluations will be kept confidential, so please answer with thought and honesty. Gift Cards are only mailed with proof of purchase, provide Sale ID # from receipt or Speedpass tag # to 1-866-334-8960. Be sure to include your mailing address.