Customer Name *

Customer Satisfaction

	0	1	2	3	4	5	6	7	8	9	10
Product Quality	Product Quality - 0	Product Quality - 1	Product Quality - 2	Product Quality - 3	Product Quality - 4	Product Quality - 5	Product Quality - 6	Product Quality - 7	Product Quality - 8	Product Quality - 9	Product Quality - 10
Satisfaction with Product Quality Records	Satisfaction with Product Quality Records - 0	Satisfaction with Product Quality Records - 1	Satisfaction with Product Quality Records - 2	Satisfaction with Product Quality Records - 3	Satisfaction with Product Quality Records - 4	Satisfaction with Product Quality Records - 5	Satisfaction with Product Quality Records - 6	Satisfaction with Product Quality Records - 7	Satisfaction with Product Quality Records - 8	Satisfaction with Product Quality Records - 9	Satisfaction with Product Quality Records - 10
Responsiveness of customer complaints	Responsiveness of customer complaints - 0	Responsiveness of customer complaints - 1	Responsiveness of customer complaints - 2	Responsiveness of customer complaints - 3	Responsiveness of customer complaints - 4	Responsiveness of customer complaints - 5	Responsiveness of customer complaints - 6	Responsiveness of customer complaints - 7	Responsiveness of customer complaints - 8	Responsiveness of customer complaints - 9	Responsiveness of customer complaints - 10
On-Time delivery performance	On-Time delivery performance - 0	On-Time delivery performance - 1	On-Time delivery performance - 2	On-Time delivery performance - 3	On-Time delivery performance - 4	On-Time delivery performance - 5	On-Time delivery performance - 6	On-Time delivery performance - 7	On-Time delivery performance - 8	On-Time delivery performance - 9	On-Time delivery performance - 10
Responsiveness in accommodating shipping schedules and changes	Responsiveness in accommodating shipping schedules and changes - 0	Responsiveness in accommodating shipping schedules and changes - 1	Responsiveness in accommodating shipping schedules and changes - 2	Responsiveness in accommodating shipping schedules and changes - 3	Responsiveness in accommodating shipping schedules and changes - 4	Responsiveness in accommodating shipping schedules and changes - 5	Responsiveness in accommodating shipping schedules and changes - 6	Responsiveness in accommodating shipping schedules and changes - 7	Responsiveness in accommodating shipping schedules and changes - 8	Responsiveness in accommodating shipping schedules and changes - 9	Responsiveness in accommodating shipping schedules and changes - 10
Rating of competitive prices	Rating of competitive prices - 0	Rating of competitive prices - 1	Rating of competitive prices - 2	Rating of competitive prices - 3	Rating of competitive prices - 4	Rating of competitive prices - 5	Rating of competitive prices - 6	Rating of competitive prices - 7	Rating of competitive prices - 8	Rating of competitive prices - 9	Rating of competitive prices - 10
Response time on quotations	Response time on quotations - 0	Response time on quotations - 1	Response time on quotations - 2	Response time on quotations - 3	Response time on quotations - 4	Response time on quotations - 5	Response time on quotations - 6	Response time on quotations - 7	Response time on quotations - 8	Response time on quotations - 9	Response time on quotations - 10
Sales Rep is easy to reach	Sales Rep is easy to reach - 0	Sales Rep is easy to reach - 1	Sales Rep is easy to reach - 2	Sales Rep is easy to reach - 3	Sales Rep is easy to reach - 4	Sales Rep is easy to reach - 5	Sales Rep is easy to reach - 6	Sales Rep is easy to reach - 7	Sales Rep is easy to reach - 8	Sales Rep is easy to reach - 9	Sales Rep is easy to reach - 10
Sales Rep is knowledgeable	Sales Rep is knowledgeable - 0	Sales Rep is knowledgeable - 1	Sales Rep is knowledgeable - 2	Sales Rep is knowledgeable - 3	Sales Rep is knowledgeable - 4	Sales Rep is knowledgeable - 5	Sales Rep is knowledgeable - 6	Sales Rep is knowledgeable - 7	Sales Rep is knowledgeable - 8	Sales Rep is knowledgeable - 9	Sales Rep is knowledgeable - 10
Sales Rep is friendly and personable	Sales Rep is friendly and personable - 0	Sales Rep is friendly and personable - 1	Sales Rep is friendly and personable - 2	Sales Rep is friendly and personable - 3	Sales Rep is friendly and personable - 4	Sales Rep is friendly and personable - 5	Sales Rep is friendly and personable - 6	Sales Rep is friendly and personable - 7	Sales Rep is friendly and personable - 8	Sales Rep is friendly and personable - 9	Sales Rep is friendly and personable - 10

0 = Bad 10 = Good

Packaging

	0	1	2	3	4	5	6	7	8	9	10
The materials are packaged in accordance with my requests	The materials are packaged in accordance with my requests - 0	The materials are packaged in accordance with my requests - 1	The materials are packaged in accordance with my requests - 2	The materials are packaged in accordance with my requests - 3	The materials are packaged in accordance with my requests - 4	The materials are packaged in accordance with my requests - 5	The materials are packaged in accordance with my requests - 6	The materials are packaged in accordance with my requests - 7	The materials are packaged in accordance with my requests - 8	The materials are packaged in accordance with my requests - 9	The materials are packaged in accordance with my requests - 10
The materials are labeled properly	The materials are labeled properly - 0	The materials are labeled properly - 1	The materials are labeled properly - 2	The materials are labeled properly - 3	The materials are labeled properly - 4	The materials are labeled properly - 5	The materials are labeled properly - 6	The materials are labeled properly - 7	The materials are labeled properly - 8	The materials are labeled properly - 9	The materials are labeled properly - 10
The materials arrive with the proper paperwork	The materials arrive with the proper paperwork - 0	The materials arrive with the proper paperwork - 1	The materials arrive with the proper paperwork - 2	The materials arrive with the proper paperwork - 3	The materials arrive with the proper paperwork - 4	The materials arrive with the proper paperwork - 5	The materials arrive with the proper paperwork - 6	The materials arrive with the proper paperwork - 7	The materials arrive with the proper paperwork - 8	The materials arrive with the proper paperwork - 9	The materials arrive with the proper paperwork - 10

0 = Bad 10 = Good

Overall Service

	0	1	2	3	4	5	6	7	8	9	10
Sales Rep	Sales Rep - 0	Sales Rep - 1	Sales Rep - 2	Sales Rep - 3	Sales Rep - 4	Sales Rep - 5	Sales Rep - 6	Sales Rep - 7	Sales Rep - 8	Sales Rep - 9	Sales Rep - 10
Quality	Quality - 0	Quality - 1	Quality - 2	Quality - 3	Quality - 4	Quality - 5	Quality - 6	Quality - 7	Quality - 8	Quality - 9	Quality - 10
On-Time Delivery	On-Time Delivery - 0	On-Time Delivery - 1	On-Time Delivery - 2	On-Time Delivery - 3	On-Time Delivery - 4	On-Time Delivery - 5	On-Time Delivery - 6	On-Time Delivery - 7	On-Time Delivery - 8	On-Time Delivery - 9	On-Time Delivery - 10
Problem Solving	Problem Solving - 0	Problem Solving - 1	Problem Solving - 2	Problem Solving - 3	Problem Solving - 4	Problem Solving - 5	Problem Solving - 6	Problem Solving - 7	Problem Solving - 8	Problem Solving - 9	Problem Solving - 10

0 = Bad 10 = Good

Additional Comments: