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Customer Satisfaction Survey
 
* Company : * Phone :
* Name : * Fax :
* Email :

A. Please rate the following service factors by matching each to its appropriate level of importance:
 
1) On Time Delivery (Whether our goods/services are delivered according to agreed schedule.)
1 (least important to you) 2 3 4 5 6 (most important to you)
 
2) Value for Money (How our pricing measures up to the goods/services we delivered.)
1 (least important to you) 2 3 4 5 6 (most important to you)
 
3) Quality of Product/Services (Whether our goods/services satisfy stated or implied needs.)
1 (least important to you) 2 3 4 5 6 (most important to you)
 
4) Customer Service (Whether we constantly and consistently meet your expectations.)
1 (least important to you) 2 3 4 5 6 (most important to you)
 
5) Responsiveness (Whether we attend to your needs in a timely and effective manner.)
1 (least important to you) 2 3 4 5 6 (most important to you)
 
6) Location of Services (Whether our location is convenient to you.)
1 (least important to you) 2 3 4 5 6 (most important to you)

B. Please indicate the level of service we provide to you by selecting the appropriate option for each and every service factor:
 
7) On Time Delivery
Very Satisfied More Than Satisfied Neutral Not Satisfied Far From Satisfied
 
8) Value For Money
Very Satisfied More Than Satisfied Neutral Not Satisfied Far From Satisfied
 
9) Quality of Product/Services
Very Satisfied More Than Satisfied Neutral Not Satisfied Far From Satisfied
 
10) Customer Service
Very Satisfied More Than Satisfied Neutral Not Satisfied Far From Satisfied
 
11) Responsiveness
Very Satisfied More Than Satisfied Neutral Not Satisfied Far From Satisfied

C. Please indicate the level of service we provide compared with other vendors that you deal with by ticking the appropriate box for each and every service factor:
 
12) On-Time Delivery
Always Better Occasionally Better Neutral Occasionally Below Always Below
 
13) Value For Money
Always Better Occasionally Better Neutral Occasionally Below Always Below
 
14) Quality of Product/Services
Always Better Occasionally Better Neutral Occasionally Below Always Below
 
15) Customer Service
Always Better Occasionally Better Neutral Occasionally Below Always Below
 
16) Responsiveness
Always Better Occasionally Better Neutral Occasionally Below Always Below

D. Please indicate your overall assessment of our service to you:
 
17) Overall Assessment
10 (Totally Satisfied) 9 8 7 6
5 4 3 2 1 (Totally Dissatisfied)

E. Please provide your feedback on our strengths and/or areas for improvement:
 

    
 

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