SANI PLASTIKOS PVT. LTD.

Date-

CUSTOMER SATISFACTION FORM

Customer Name :

Customer Representative :

Representatives Designation :-

Tick Mark the appropriate option:-

1 Are you satisfied with the quality of our products? (Q)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

2 Do you receive delivery on time? (D)

a) Every b) Most Times c) Some Times d) Seldom e) Never

Time

3 Are you satisfied with the packaging (Palletisation) of AVM ? (Q)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

4 How often do you find errors in the billing ? (S)

a) Never b) Seldom c) Some Times d) Most Times e) Every Times

5 Are you satisfied with reply to your any enquiries ? (S)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

6 How satisfied are you with the number of visits made by our representative to your work ? (S)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

7 Do you find right person at your work place? (S) 4

a) Every b) Most Times c) Some Times d) Seldom e) Never

Times

Format No : SP/SLS/03 Page 1 of 3

SANI PLASTIKOS PVT. LTD.

CUSTOMER SATISFACTION FORM

8 Are you satisfied with the knowledge, continuousness & attentiveness of our representative? (S)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

9 Are you satisfied with the post visit response from us? (S)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

10 How satisfied you are with your complaints getting resolved from us? (Q)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

11 Do you find our paper work very cumbersome? (S)

a) Never b) Seldom c) Some Times d) Most Times e) Every Times

12 How satisfied you are with the response to your enquiry before contract? (S)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

13 Are you satisfied on our efforts of new product developed of your company? (S)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

14 Do you find our reception treatment cordial? (S)

a) Every b) Most Times c) Some Times d) Seldom e) Never

Times

15 Do you find your problems are solved by our management? (S)

a) Every b) Most Times c) Some Times d) Seldom e) Never

Times

16 How satisfied are you with the support given by us in improving quality and processes at our end? (Q)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

Format No : SP/SLS/03 Page 2 of 3

SANI PLASTIKOS PVT. LTD.

CUSTOMER SATISFACTION FORM

17 How do you find the consistency of our product? (Q)

a) Highly b) Satisfied c) Partially d) Dissatisfied e) Highly

Satisfied Satisfied Dissatisfied

18 How much follow up you are required to do for timely delivery? (D)

a) Never b) Seldom c) Some Times d) Most Times e) Every Times

19 In your last visit what problems did you face?

20 Any problems you faced in your recent orders?

21 Do you faced any field failure problem due to our product ?

22 Please suggest to improve our performance?

Note :- S - Denotes Service related

D - Denotes Delivery related
Q - Denotes Quality related

Prepared By Approved By
Format No : SP/SLS/03 Page 3 of 3