9/4/22, 6:40 PM Feedback Form

Feedback Form
*Required

1. Name *

2. Mobile Number *

3. Date of Birth *

Example: 7 January 2019

4. How satisfied are you with our services?

*

Mark only one oval.

1 2 3 4 5

Lowest Highest

5. How did you get to know about our services?

*

Tick all that apply.

Website
Advertisement
Friends
Relatives

Other:

https://docs.google.com/forms/d/1vWyIwQ1-ICPWvXrUR0hSSW7UjdkBDaVnI3ylbmcMZIc/edit 1/3
9/4/22, 6:40 PM Feedback Form

6. What is the likelihood that you will retake our

services?
*

Mark only one oval.

Extremely

Very

Moderately

Slightly

Unlikely to retake

7. Will
you recommend us to your friends or relatives? *

Mark only one oval.

Yes

No

Maybe

8. Would you like a representative to contact you?

*

Mark only one oval.

Yes

No

Maybe

9. Tell
us how we can improve our service? *

https://docs.google.com/forms/d/1vWyIwQ1-ICPWvXrUR0hSSW7UjdkBDaVnI3ylbmcMZIc/edit 2/3
9/4/22, 6:40 PM Feedback Form

This content is neither created nor endorsed by Google.

 Forms

https://docs.google.com/forms/d/1vWyIwQ1-ICPWvXrUR0hSSW7UjdkBDaVnI3ylbmcMZIc/edit 3/3