Customer Satisfaction Survey

The survey should take less than 2 minutes to complete. Thank you in advance for taking the time.

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* 1.
Please rate our overall performance in these categories:

	Excellent	Very Good	Average	Poor	Unacceptable
Product Quality	Product Quality Excellent	Product Quality Very Good	Product Quality Average	Product Quality Poor	Product Quality Unacceptable
Product Performance	Product Performance Excellent	Product Performance Very Good	Product Performance Average	Product Performance Poor	Product Performance Unacceptable
Responsiveness	Responsiveness Excellent	Responsiveness Very Good	Responsiveness Average	Responsiveness Poor	Responsiveness Unacceptable
Customer Service	Customer Service Excellent	Customer Service Very Good	Customer Service Average	Customer Service Poor	Customer Service Unacceptable
On Time Delivery	On Time Delivery Excellent	On Time Delivery Very Good	On Time Delivery Average	On Time Delivery Poor	On Time Delivery Unacceptable
Overall Satisfaction	Overall Satisfaction Excellent	Overall Satisfaction Very Good	Overall Satisfaction Average	Overall Satisfaction Poor	Overall Satisfaction Unacceptable

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* 2. In what way(s) could we improve?

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* 3. Please provide any additional comments:

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* 4. Please enter your contact information:

Name

Company

Address 1

Address 2

City/Town

State/Province

Zip/Postal Code

Country

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* 5. Please enter your email address (Required):

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* 6.
Would you like a response to your comments/feedback?

Yes

No

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* 7. If Yes to question 6, please indicate preferred method:

Email

Phone - Please enter your phone number below:

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* 8. Best time to call: