Feedback Form to maybe replace listen 360

We would decide what questions we will ask, yada yada...
Idea... Each night an autoCron job runs and downloads today's sales activity from CCS via API. It then text messages each customer asking if they would like to leave feedback on their experience and displays a link to this page for them to do so.
Please enable JavaScript in your browser to complete this form.

Rate Your Experience

Image Quality
ExcellentGoodAveragePoor
Excellent
Good
Average
Poor
Shipping
ExcellentGoodAveragePoor
Excellent
Good
Average
Poor
Ease of ordering
ExcellentGoodAveragePoor
Excellent
Good
Average
Poor
Conditional Field... If customer chooses 3 or less it will ask if they would like to open a Help Desk ticket, if they say Yes it will save this form to include the CCS data in the ticket then it will take them to the ticket page. If they choose 4 or 5 it will NOT open a ticket but create an testimonial and place it into queue for approval before adding to the testimonial page.
Hidden from user or not?: First Name - Obtained from CCS via API

This page is still work in progess and does not show on the website menus.

Customer Service 800-482-0321 or 734-677-3400