CUSTOMER SATISFACTION FEEDBACK FORM - (you may print it and send it to us)

 

It is our endeavor at Unicare Emergency Equipment to ensure Customer Satisfaction with our Product & service.

In order to enable us to achieve this goal, we solicit your support by requesting you to fill up this form by applying a tick mark against each criteria listed as Excellent, Good, Average, Fair or Poor as per your perception and experience and return same to us.

Review Period: April, 200__  to March, 200__

Products Supplied: ______________________________________________________________

       ____________________________________________________________________________

       ____________________________________________________________________________

 

Sr. No.

 

Criteria

Rating

Excellent

Good

Average

Fair

Poor

1

Quality of our Products.

 

 

 

 

 

2.

Quality of Technical Support provided by Sales Reps.

 

 

 

 

 

3.

Quality & Speed of response to enquiries

 

 

 

 

 

4.

Quality & speed of reponse to complaints

 

 

 

 

 

5.

Adherence to Delivery commitments

 

 

 

 

 

6.

Quality of Packaging / Operating Instructions provided on our products

 

 

 

 

 

7.

Product Pricing as compared o Quality (Value for money)

 

 

 

 

 

8.

Appearance / Attitude/ Behaviour of Sales Reps.

 

 

 

 

 

9.

Adequacy of visit by Sales Representatives

 

 

 

 

 

10.

Attitude/Behaviour/ Response of Office / Factory Staff

 

 

 

 

 

 

 

 

 

 

 

 

 

Remarks : ______________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

 

Sign : __________________________                                    Date : ____________________

Name : __________________________________________________________________________

Designation : ____________________________________________________________________

Name of Company : _____________________________________________________________