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Feedback
Thank you for being our customer. Please help us improve our offers to you by completing this feedback form:
1. What is your overall satisfaction rating with our company?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
2. Please let us know why you feel that way.
3. Would you recommend our services to a friend/colleague?
Yes
No
Please enter the email of friends (separate each address with a comma) to whom you would like to recommend our services
4. Please rate your level of satisfaction with our sales representatives in the following areas.
(5-Excellent 4-Good 3-Average 2-Needs Improvement 1-Poor)
5
4
3
2
1
Responsiveness
Professionalism
Understanding of your needs
Product & Offers knowledge
5. How frequently do you contact Customer Service?
Once a day
Once a week
Once a month
Once in 6 months
Yearly or less often
6. Based upon your overall experience, please rate your satisfaction with Customer Service in the following areas:
(5-Excellent 4-Good 3-Average 2-Needs Improvement 1-Poor)
5
4
3
2
1
Promptness in answering
Issue resolution/Knowledge of the agent
Helpfulness of Representative
Ease of contacting Customer Service
Overall quality of issue handling
7. If you have any additional comments about how we can improve your satisfaction with our products and services, please fill them here.
8. How important are the following characteristics to you when purchasing a product like ours?
(5-Very important 4-Important 3- Average 2-Not so important 1-Not important)
5
4
3
2
1
Price of the product
Purchase experience
After purchase service (customer service etc…)
9. What suggestions do you have to imporve our offers?
10. May we contact you about any of your responses?
Yes
No
Contact information if applicable:
*
First Name:
*
Last Name:
Telephone:
*
Mobile:
*
Email Address:
11. Would you prefer to be contacted via:
Phone
Email
In Person
12. How long have you used our services?
Less than 1 year
More than 1 year
13. What is your gender?
Male
Female
14. Select Age Criteria?
select Age Criteria
Below 20 years
20-30 years
30-40 years
40-50 years
Above 50 years
15. What is your employment status ?
Full Time
Part tme
Unemployed
Retired
Student
Thank you for your time and valuable input
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