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CUSTOMER SURVEY
Name
*
Clinic Name
*
E-mail Address
*
How long have you used our services?
Rows
Less than 1 month
1-3 months
3-6 months
6 months - 1 year
More than 1 year
Service usage
How satisfied are you with our services?
Rows
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
Customer Service
Sales Representative
Result Turnaround Time
Test Result Format
Ease of use of our forms
Website Tools
Overall Satisfaction
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What are you most satisfied with?
What are you least satisfied with?
What can we do to better your overall satisfaction?
Do our services meet your expectations?
Yes
Other
______________________________________________________________________________________
Additional comments
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