Customer Feedback Form: Marks Obtained

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DOC.

PR-621-F-01
Issue No. 01
REV:00
DATE: 01.12.2013
PAGE: 1 of 1

CUSTOMER FEEDBACK FORM

Date:

Customer Name:

Product(s) Purchased:

Assessment (Please tick the relevant box)

Sr.
No.
Attribute
Excellent
Very
Good
Good Satisfactory Poor
5 4 3 2 1
1. Quality
2. Timely Delivery
3. Documentation (Billing, etc.)
4. Response & Support Service
5. Cost

YOUR SUGGESTIONS FOR IMPROVEMENT / OTHER REMARKS :





NAME & SIGNATURE
(FOR USE BY)


Marks Obtained
Customer Satisfaction index (CSI) : ------------------- X 100
Total Marks


------------------- X 100 % = %


Follow up, if any:





Note :-

If customer does not return this format (duly filled) within one month, he will be
considered satisfied.







DOC. PR-621-F-01
Issue No. 01
REV:00
DATE: 01.12.2013
PAGE: 1 of 1

CUSTOMER FEEDBACK FORM

Besides this format, repeated orders received within a specified period (three
months, six months or one year) will be considered as the implied indication of
customer satisfaction.

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