Contact Information* Required Fields

• * First Name:  
• * Last Name:  
• * Street Address 1:  
• Street Address 2:
• * City:  
• * State: State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia 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:    
• * Phone:    
• Email Address:  

Complaint Information

• Please provide a brief summary of your complaint:
  
  • Date of the call/visit(MM/DD/YYYY):  
  • Approximate time of the call/visit: Time... 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM 12:00 PM 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM
• Did solicitor state his/her company? YesNo If yes, what was the company name:
• Did you have any reason to beleive the person represented Dominion East Ohio? YesNo If so, why?
• Did you know - right away - what the solicitor was selling or offering? YesNo
• Were any claims made at all about saving money on your gas bill? YesNo
• Did the person thoroughly explain the reason for the call or visit? YesNo
• Was any statement made about Dominion no longer offering natural gas to its customers? YesNo
• Did you have any reason to question the truthfulness of the person's statements? YesNo
• Did you understand the offer presented to you and that you would be switching your gas supply? YesNo
• Did the solicitor ask you for your account number or a copy of your DEO bill before you made up your mind about the offer? YesNo
• Did you feel that the sales person used high-pressure tactics? YesNo If so, why?
• Did you — at any time — try to end the conversation with the solicitor? YesNo
• If you were not interested in the offer, did the solicitor accept your decision in a professional manner? YesNo
• Did the person do or say anything suspicious or make you feel uncomfortable in any way? YesNo If so, why?

For Door-to-door Solicitations Only

• Did solicitor display an ID badge? YesNo
• Did solicitor leave when business was concluded? YesNo
• Do you recall what color clothing the solicitor was wearing? YesNo