Customer Feedback Form

LABS, Inc. is committed to providing a quality service and achieving the highest standards. One of the ways in which we continue to improve our service is by listening and responding to the views of our clients. We have provided an electronic form to give you another option for submitting your issue.

Please ensure that you provide us with the following:

• Your account number;
• Sample accession number and ID;
• your name;
• what your compliment/complaint is about;
• Give us as much relevant detail about your compliment/complaint as possible, for example dates, names; and
• If filing a complaint, say what you feel is wrong and what we can do to improve our service to you, the client.

* = Indicates Required Field
* Client Name:
* Account Number:
* Accession Number:
* ID Number:
Contact Information Details
* Contact Name:
Phone:	format (xxx) xxx-xxxx
* Email Address:	format (test@test.com)
* Street Address:
Street Address (con't):
* City:
* State:	Alabama Alaska Arizona Arkansas Califonia Colorado Connecticut Delaware Washington DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
* Zip Code:
Do you require a Response Letter?   Yes   No
Description of Compliment/Complaint:
Please enter text in image: