Information
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Customer Account #
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Customer Name (Last, First)
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Office:
- Orlando
- Lakeland
- Ocala
- Port St Lucie
- Jacksonville
- Gainesville
- Tallahassee
- Ft Myers
- Tampa
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Conducted on
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Prepared by
Tech Statement
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Tech Name (First, Last)
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Please provide a written statement from the initial call, when you arrived on the job site to the time that you left. Make sure to include type of work completed, any and all conversation you may have had with the customer, noticed anything unusual, condition of the home, if customer was with you during the process, etc.
Manager Statement
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Is this a valid damage caused by the tech that should result in Damage Points being given? (Manager Opinion at time no guarantee this will be followed 100%)
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Was the technician following procedure when the damage occurred? Explain
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Define the Root Cause of Damage (What action did the tech take or not take that directly caused this damage?)
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What is your recommended course of action for this claim?
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What is the customer seeking to resolve the claim?
