Customer Satisfaction Survey
Questions marked with an asterisk (*) are mandatory.
The survey should take less than 2 minutes to complete. Thank you in advance for taking the time.
1

Please rate our overall performance in these categories:

1
Excellent		2
Very Good		3
Average		4
Poor		5
Unacceptable
Product Quality
Product Performance
Responsiveness
Customer Service
On Time Delivery
Overall Satisfaction
2
In what way(s) could we improve?
3
Please provide any additional comments:
4
Please enter your contact information:
Name:
Company:
Address 1:
Address 2:
City/Town:
State/Province:
Zip/Postal Code:
Country:
5
* Please enter you email address (Required):
6

Would you like a response to your comments/feedback?
7
If Yes to question 6, please indicate preferred method:
Email
Phone - Please enter your phone number below:
8
Best time to call: