Customer Satisfaction Survey Form Template

Customer Service Survey

Please take a moment to fill out this survey
Company Name
Contact

First NameLast Name
Phone Number
Email
example@example.com
Customer Service

Using a scale of 1 to 5 with 1 being below average and 5 being excellent , please rate how we perform in the following areas by marking the appropiate number.

Customer Service

	1	2	3	4	5
When contacting a member of our staff how would you rate them
How would you rate the professionalism and courteousness of our staff?
After requesting information, how would you rate the accuracy of the information provided to you?
How would you rate the manner in which problem situations are handled? If Applicable

Additional Comments
PRODUCT QUALITY

Based on the experience with our products, please rate the following (1= Poor, 5= Excellent) by marking the appropiate number

Production Quality

	1	2	3	4	5
Product Conformity to quality requirements
Speed in manufacturing
Packaging

Additional Comments
Shipping

Based on the experience with our products, please rate the following (1= Poor, 5= Excellent) by marking the appropiate number

Shipping

	1	2	3	4	5
My shipments are received on the date requested or expected
Order are processed and shipped accurately
Products are received in good condition

Additional Comments
Thank you. We welcome any and all suggestions to help us improve the quality of our products and services
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