In our ongoing effort to improve the quality of our products and service we ask you to take a moment to complete this Customer Satisfaction Survey Form. Your input will assist us significantly in continuing to improve our product quality and responsiveness to your requirements. Thank you in advance for your assistance.
 

 
Name :
Company Name:
Title :
Phone :
Address 1 :
Address 2 :
City :
State :
Zip :
Country :
Email :
Newsletter Subscription :
 
Choose One That Best Describes Your Experience
 
Would you recommend us to others?
Yes
No
 
Courtesy of our personal
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
N/A
 
Responsiveness of our sales personnel
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
 
Invoicing
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
N/A
 
On-time delivery
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
N/A
 
salesperson knowledge of product
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
N/A
 
Responsiveness to shipping schedules and changes
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
 
Pricing
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
 
Responsiveness of our customer service department
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
N/A
 
Overall quality of product ordered
Very Satisfied
Satisfied
Somewhat Satisfied
Somewhat Unsatisfied
Completely Unsatisfied
N/A
 
 
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