Customer Satisfaction Survey Template 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. How likely is it that you would recommend Reliable Medical Supply 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 * 3. How well do our services meet your needs? Extremely well Very well Somewhat well Not so well Not at all well Question Title * 4. 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 * 5. How long have you been a customer of Reliable Medical Supply? 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 * 6. How likely are you to use Reliable Medical Supply again in the future? Extremely likely Very likely Somewhat likely Not so likely Not at all likely Question Title * 7. Do you have any other comments, questions, or concerns? Done