Customer Satisfaction Survey

1Your Name and Company Name:
2How do you rate us in terms of:
PoorFairGoodVery GoodExcellentDo Not Know or N/A
Ease of order placement?
Method of order placement?
Service from your Sales Representative?
Overall delivery service?
Accounts receivable activities?
The quality of our products and services?
Our friendliness, attitude, etc.?
The value you receive from us vs. the costs you incur?
Your overall satisfaction with our organization?
3Do you plan to continue using our products/services?


4On a scale of 1 to 10, how likely is it that you would recommend our products/services to a friend or colleague? Please assign a value between 1 and 10 (10 being the highest).
12345678910
Recommendation                                                                   
5Is there anything you particularly like about doing business with us?
6How could we improve your satisfaction?
7If you would like to receive future communications via electronic mail please provide your e-mail address below: