Sample Customer Satisfaction Survey

This customer satisfaction survey is intended to find out what you, our valued customers, think of our products and product support. It is a short survey that takes less than 5 minutes. Your responses will help us better serve you in the future.
1.
Approximately when did you first use our services?
(mm/dd/yyyy)
2.
How would you rate us on the following dimensions:     
1 being the lowest, 5 being the best     
If you have no experience with one of the questions, do not select any value.
 1   2   3   4   5 
Salesperson Knowledge 
Salesperson Attitude 
Payment Processing 
Delivery Services 
Customer Support 
Product Quality 
Product Aesthetics 
3.
Do you have any outstanding issues that we have not dealt with to a satisfactory manner?
4.
Are there any other comments that you would like to share with us?
5.
Would you like us to contact you with regard to this survey response?
Yes
No
6.
Please enter your name
7.
Please enter your contact information, i.e. email address, phone number, or account number.
    

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