How did you first hear about us?

 Online Search
 Social Media
 Family Friend
 Show
 Other - please state:

Have you bought from us before?

 Yes
 No

What have you purchased from us?

(please list the type of wine and whether you purchased a case or a single bottle)

How would you rate us?

Wines:
 Excellent   Very Good   Average   Poor   Very Poor

Service:
 Excellent   Very Good   Average   Poor   Very Poor

Value:
 Excellent   Very Good   Average   Poor   Very Poor

Our Looks:
 Excellent   Very Good   Average   Poor   Very Poor

Would you buy from us again?

 Yes
 No - If not, please let us know why you would not buy from us again, so that we can improve -

Would you recommend Premier Estates Wine to your friends and family?

 Yes
 No - If not, please let us know why you would not recommend us, so that we can improve -

Your Name:           Your Email Address:

Your Birthday: