Customer Satisfaction Survey

Thank you for being a customer. Please help us improve our product and our service to you by completing this survey.

1. What is your overall satisfaction rating with our company?
1 Very Satisfied	2 Somewhat Satisfied	3 Neither Satisfied Nor Dissatisfied	4 Somewhat Dissatisfied	5 Very Dissatisfied
Please tell us why you feel that way: ________________________________________
2. How likely would you recommend our products?
1 Very Likely	2 Somewhat Likely	3 Neither Likely Nor Unlikely	4 Somewhat Unlikely	5 Very Unlikely
Please tell us why you feel that way: ________________________________________
3. How likely are you to purchase a product again from our company?
1 Very Likely	2 Somewhat Likely	3 Neither Likely Nor Unlikely	4 Somewhat Unlikely	5 Very Unlikely
________________________________________ Please rate your level of satisfaction with your sales representative in the following areas :
4. Responsiveness
1 Very Satisfied	2 Somewhat Satisfied	3 Neither Satisfied Nor Dissatisfied	4 Somewhat Dissatisfied	5 Very Dissatisfied
5. Professionalism
1 Very Satisfied	2 Somewhat Satisfied	3 Neither Satisfied Nor Dissatisfied	4 Somewhat Dissatisfied	5 Very Dissatisfied
6. Understanding of my needs
1 Very Satisfied	2 Somewhat Satisfied	3 Neither Satisfied Nor Dissatisfied	4 Somewhat Dissatisfied	5 Very Dissatisfied
If you have any additional comments about how we can improve your satisfaction with our products and services, please fill them in here. ________________________________________ Required Fields:
Your name:
Company Name:
Telephone Number:
E-mail:
City:
State: