Customer Feed Back

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Customer Feedback form
F-04/01
CUSTOMER FEED BACK
Issue #
: 02
Revision #: 02
Quality Control Center
Issue Date : 20/02/2007
QCC Ref #: ____________________
Date: ______________
Dear Customer,
Our major objective is to achieve the customer satisfaction and we are constantly putting in
efforts to achieve this goal. In order to improve our services, we need your feed back and
valuable suggestions. You are requested to fill in the following questionnaire and mail/fax it at
the address given below.
1. Feedback Regarding:
Name of Section(s):_________________________________
(Optional) Name of Person(s): _______________________
2. Name and address of the customer:
3. Delivery of Report
Excellent
Good
Fair
Unsatisfactory
4. Response to enquiries
Excellent
Good
Fair
Unsatisfactory
5. Response against complaints
Excellent
Good
Fair
Unsatisfactory
6. Quality of service rendered
Excellent
Good
Fair
Unsatisfactory
7. Attitude of our staff
Excellent
Good
Fair
Unsatisfactory
8. Any weak area you want to identify:
___________________________________________________________________________
___________________________________________________________________________
9. Remarks/suggestions for further improvement:
___________________________________________________________________________
__________________________________________________________________________
10. Complaint (if any):
___________________________________________________________________________
___________________________________________________________________________
Customer’s Name and
Signature
____________________
Sample Superintendent
_______________
Quality Manager

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