Customer Feedback Survey

In order for us to understand your needs and to ensure that we continue to meet your expectations, we would be grateful if you could spare a few moments of your time to complete the questionnaire below.

	Poor	Fair	Average	Good	Excellent
How satisfied are you with the quality of our products?	How satisfied are you with the quality of our products? Poor	How satisfied are you with the quality of our products? Fair	How satisfied are you with the quality of our products? Average	How satisfied are you with the quality of our products? Good	How satisfied are you with the quality of our products? Excellent
How satisfied are you with the quality of our customer service team?	How satisfied are you with the quality of our customer service team? Poor	How satisfied are you with the quality of our customer service team? Fair	How satisfied are you with the quality of our customer service team? Average	How satisfied are you with the quality of our customer service team? Good	How satisfied are you with the quality of our customer service team? Excellent
How satisfied are you with the quality of our sales team?	How satisfied are you with the quality of our sales team? Poor	How satisfied are you with the quality of our sales team? Fair	How satisfied are you with the quality of our sales team? Average	How satisfied are you with the quality of our sales team? Good	How satisfied are you with the quality of our sales team? Excellent
How satisfied are you with the delivery/collection service that we offer?	How satisfied are you with the delivery/collection service that we offer? Poor	How satisfied are you with the delivery/collection service that we offer? Fair	How satisfied are you with the delivery/collection service that we offer? Average	How satisfied are you with the delivery/collection service that we offer? Good	How satisfied are you with the delivery/collection service that we offer? Excellent
Adequate instructions are provided for the safe use of the equipment?	Adequate instructions are provided for the safe use of the equipment? Poor	Adequate instructions are provided for the safe use of the equipment? Fair	Adequate instructions are provided for the safe use of the equipment? Average	Adequate instructions are provided for the safe use of the equipment? Good	Adequate instructions are provided for the safe use of the equipment? Excellent
Our staff are courteous and helpful?	Our staff are courteous and helpful? Poor	Our staff are courteous and helpful? Fair	Our staff are courteous and helpful? Average	Our staff are courteous and helpful? Good	Our staff are courteous and helpful? Excellent
Overall customer satisfaction/service rating	Overall customer satisfaction/service rating Poor	Overall customer satisfaction/service rating Fair	Overall customer satisfaction/service rating Average	Overall customer satisfaction/service rating Good	Overall customer satisfaction/service rating Excellent
Overall satisfaction with our product quality	Overall satisfaction with our product quality Poor	Overall satisfaction with our product quality Fair	Overall satisfaction with our product quality Average	Overall satisfaction with our product quality Good	Overall satisfaction with our product quality Excellent

Poor

Fair

Average

Good

Excellent

How satisfied are you with the quality of our products?

How satisfied are you with the quality of our products? Poor

How satisfied are you with the quality of our products? Fair

How satisfied are you with the quality of our products? Average

How satisfied are you with the quality of our products? Good

How satisfied are you with the quality of our products? Excellent

How satisfied are you with the quality of our customer service team?

How satisfied are you with the quality of our customer service team? Poor

How satisfied are you with the quality of our customer service team? Fair

How satisfied are you with the quality of our customer service team? Average

How satisfied are you with the quality of our customer service team? Good

How satisfied are you with the quality of our customer service team? Excellent

How satisfied are you with the quality of our sales team?

How satisfied are you with the quality of our sales team? Poor

How satisfied are you with the quality of our sales team? Fair

How satisfied are you with the quality of our sales team? Average

How satisfied are you with the quality of our sales team? Good

How satisfied are you with the quality of our sales team? Excellent

How satisfied are you with the delivery/collection service that we offer?

How satisfied are you with the delivery/collection service that we offer? Poor

How satisfied are you with the delivery/collection service that we offer? Fair

How satisfied are you with the delivery/collection service that we offer? Average

How satisfied are you with the delivery/collection service that we offer? Good

How satisfied are you with the delivery/collection service that we offer? Excellent

Adequate instructions are provided for the safe use of the equipment?

Adequate instructions are provided for the safe use of the equipment? Poor

Adequate instructions are provided for the safe use of the equipment? Fair

Adequate instructions are provided for the safe use of the equipment? Average

Adequate instructions are provided for the safe use of the equipment? Good

Adequate instructions are provided for the safe use of the equipment? Excellent

Our staff are courteous and helpful?

Our staff are courteous and helpful? Poor

Our staff are courteous and helpful? Fair

Our staff are courteous and helpful? Average

Our staff are courteous and helpful? Good

Our staff are courteous and helpful? Excellent

Overall customer satisfaction/service rating

Overall customer satisfaction/service rating Poor

Overall customer satisfaction/service rating Fair

Overall customer satisfaction/service rating Average

Overall customer satisfaction/service rating Good

Overall customer satisfaction/service rating Excellent

Overall satisfaction with our product quality

Overall satisfaction with our product quality Poor

Overall satisfaction with our product quality Fair

Overall satisfaction with our product quality Average

Overall satisfaction with our product quality Good

Overall satisfaction with our product quality Excellent

Customer Feedback

Question Title

* 1. Contact Information

Question Title

* 2. What products did you most recently purchase from us?

Question Title

* 3. Using the scale below, please rate the following.

Question Title

* 4. Do you know who your local sales representative is?

Question Title

* 5. Do you have your local sales representative contact details?

Question Title

* 6. Do you have any other comments, questions or concerns?