What is your Company Name
1. What is your overall satisfaction rating with our company?
Please Choose
Very Satisfied
Somewhat
Satisfied
Neither
Satisfied Nor Dissatisfied
Somewhat
Dissatisfied
Very Dissatisfied
2. Please tell us why you feel that way:
3. How likely are you to recommend our product to a friend or colleague?
Please Choose
Very Likely
Somewhat
Likely
Neither
Likely Nor Unlikely
Somehwat
Unlikely
Very Unlikely
4. Please tell us why you feel that way:
5. Please rate your level of satisfaction with your sales representative in the following areas:
Responsiveness:
Please Choose
Very
Satisfied
Somewhat
Satisfied
Neither
Saitisfied Nor Dissatisfied
Somewhat
Dissatisfied
Very
Dissatisfied
Professionalism:
Please Choose
Very
Satisfied
Somewhat
Satisfied
Neither
Saitisfied Nor Dissatisfied
Somewhat
Dissatisfied
Very
Dissatisfied
Understanding
of my needs:
Please Choose
Very
Satisfied
Somewhat
Satisfied
Neither
Saitisfied Nor Dissatisfied
Somewhat
Dissatisfied
Very
Dissatisfied
6. Please rate your level of satisfaction with your customer service representative in the following areas:
Responsiveness:
Please Choose
Very
Satisfied
Somewhat
Satisfied
Neither
Saitisfied Nor Dissatisfied
Somewhat
Dissatisfied
Very
Dissatisfied
Professionalism:
Please Choose
Very
Satisfied
Somewhat
Satisfied
Neither
Saitisfied Nor Dissatisfied
Somewhat
Dissatisfied
Very
Dissatisfied
Understanding
of my needs:
Please Choose
Very
Satisfied
Somewhat
Satisfied
Neither
Saitisfied Nor Dissatisfied
Somewhat
Dissatisfied
Very
Dissatisfied
7. If you have any additional comments about how we can improve your satisfaction with our products and services please fill them in here:
8. Thinking of similar services offered by other companies, how would you compare our services offered to them?
Much better
Please Choose
Somewhat
better
About the
same
Somewhat
worse
Much worse
Don't know
9. Would you utilize our services again?
Please Choose
Definitely
Probably
Not sure
Probably not
Definately
not
10. Why do you feel that way about purchasing our service again?
11. May we contact you about any of your responses?
Please Choose
No
Yes
Contact Information, if applicable: