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 Feedback
Thank you for being our customer. Please help us improve our offers to you by completing this feedback form:
 
1. What is your overall satisfaction rating with our company?
   
 
  Satisfied
  Neither satisfied nor dissatisfied
  Dissatisfied
  Very dissatisfied
 
2. Please let us know why you feel that way.
   
 
 
3. Would you recommend our services to a friend/colleague?
   
  Yes
  No
 
Please enter the email of friends (separate each address with a comma) to whom you would like to recommend our services
   
 
 
4. Please rate your level of satisfaction with our sales representatives in the following areas.
 
(5-Excellent 4-Good 3-Average 2-Needs Improvement 1-Poor)
 
      5 4 3 2 1
  Responsiveness  
  Professionalism  
  Understanding of your needs  
  Product & Offers knowledge  
 
5. How frequently do you contact Customer Service?
   
 
  Once a week
  Once a month
  Once in 6 months
  Yearly or less often
 
 
6. Based upon your overall experience, please rate your satisfaction with Customer Service in the following areas:
 
(5-Excellent 4-Good 3-Average 2-Needs Improvement 1-Poor)
 
      5 4 3 2 1
  Promptness in answering  
  Issue resolution/Knowledge of the agent  
  Helpfulness of Representative  
  Ease of contacting Customer Service  
  Overall quality of issue handling  
 
 
7. If you have any additional comments about how we can improve your satisfaction with our products and services, please fill them here.
   
 
   
8. How important are the following characteristics to you when purchasing a product like ours?
 
(5-Very important 4-Important 3- Average 2-Not so important 1-Not important)
 
      5 4 3 2 1
  Price of the product  
  Purchase experience  
  After purchase service (customer service etc…)  
 
9. What suggestions do you have to imporve our offers?
   
 
 
10. May we contact you about any of your responses?
   
  Yes
  No
   
  Contact information if applicable:
   
* First Name:
* Last Name:
  Telephone:
* Mobile:
* Email Address:
 
11. Would you prefer to be contacted via:
   
 
  Email
  In Person
 
12. How long have you used our services?
   
 
  More than 1 year
 
13. What is your gender?
   
 
  Female
 
14. Select Age Criteria?
   
 
 
15. What is your employment status ?
   
 
 
Thank you for your time and valuable input
 
 
 
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