Customer Feedback Question Title * 1. Overall, how satisfied or dissatisfied are you with our company? Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied Question Title * 2. Overall, are you satisfied or dissatisfied with the customer service you received from our company? Extremely satisfied Very satisfied Somewhat satisfied Not so satisfied Not at all satisfied Question Title * 3. How politely did our customer service representative treat you? Extremely politely Very politely Moderately politely Slightly politely Not at all politely Question Title * 4. Do you like our customer service, neither like nor dislike it, or dislike it? Like a great deal Like a moderate amount Like a little Neither like nor dislike Dislike a little Dislike a moderate amount Dislike a great deal Question Title * 5. How well do our products meet your needs? Extremely well Very well Somewhat well Not so well Not at all well Question Title * 6. How would you rate the quality of the product? Very high quality High quality Neither high nor low quality Low quality Very low quality Question Title * 7. How responsive have we been to your questions or concerns about our products? Extremely responsive Very responsive Somewhat responsive Not so responsive Not at all responsive Not applicable Question Title * 8. How long have you been a customer of our company? This is my first purchase Less than six months Six months to a year 1 - 2 years 3 or more years I haven't made a purchase yet Question Title * 9. How likely are you to purchase any of our products again? Extremely likely Very likely Somewhat likely Not so likely Not at all likely Question Title * 10. How likely is it that you would recommend this company to a friend or colleague? Not at all likely Extremely likely 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title * 11. How satisfied are you with the delivery process? Very Satisfied Satisfied Somewhat satisfied Not satisfied Question Title * 12. Was the driver professional and courteous? Question Title * 13. Do you have any other comments, questions, or concerns? Question Title * 14. Contact Information Name Company City/Town State/Province Email Address Phone Number Done
