Customer satisfaction at an IT firm

Dear Customer,
We thank you for being our regular client receiving our services. We wish to have your
valuable feedback on the quality of the services you have received till date, so that we will be
able to understands you better to provide better services. This will also help us to serve you
better. Please fill the questionnaire by spending 5 min of your valuable time.

Thank you.

1. May we know your good name…………

2. Customer id………………
3. Age…………….
4. Gender a. Male (0) b. Female (1) c. Others (2)
5. Area
a. Southern India (1)
b. Northern India (2)
c. From Others parts of India (3)
6. Educational qualification
a. Post-graduation (1)
b. Above Post-graduation (2)
c. Under-graduation or Technical (3)
7. Occupation
a. Business (1)
b. IT related (2)
c. Govt. (3)
d. Others (4)
8. Income
a. < 50,000 (1)
b. 50,000 to 1,00,000 (2)
c. >=1,00,000 (3)
9. Nativity
a. Same city (1)
b. Outside the city (2)
 10. Frequency of visit to the firm to receive the services
a. First time visit (1)
b. 1-3 times visit (2)
c. 3-5 times visit (3)
d. >=5 times visit (4)
11. Type of service
a. Paying the bills (1)
b. Registration for govt. policies (2)
c. Travelling abroad help (3)
d. Updating the existing software (4)
e. Others (5)
12. Amount spent
a. <10000 (1)
b. 10000-20000 (2)
c. 20000-30000 (3)
d. >=30000 (4)
13. Average time spent at the firm to receive the service
a. 1-10 min (1)
b. 10 min -20 min (2)
c. 20 min -30min (3)
d. >=30 min (4)
14. Give your satisfaction levels on a scale of 1 to 5

Strongly Agree-4 Neutral-3 Disagree-2 Strongly

agree-5 Disagree-1
Satisfaction-Service
Satisfaction-Reception
Satisfaction-Customer care
Satisfaction-Ambience
Satisfaction-Negotiation
Satisfaction-Delivery
Satisfaction-Solutions
Satisfaction-Follow-up