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In thinking about your most recent experience with [COMPANY], how satisfied are you with the customer service you received:
 
Very satisfied
 
Satisfied
 
Neutral
 
Dissatisfied
 
Very dissatisfied
 
N/A
 
 
 
If you were not totally satisfied with the customer service, will you please describe the reason(s) for your dissatisfaction?
   
 
 
 
Will you please describe the aspects of the service that you were completely satisfied with?
   
 
 
 
How satisfied are you with the process of getting your question resolved.
 
Very satisfied
 
Satisfied
 
Neutral
 
Dissatisfied
 
Very dissatisfied
 
 
 
How would you rate the [PRODUCT]'s value for money:
 
Excellent
 
Good
 
Fair
 
Poor
 
Not sure
 
 
 
What aspects of [PRODUCT] were of no benifite to you?
   
 
 
 
What aspects of [PRODUCT] were most beneficial for you?
   
 
 
 
The customer service representative was very courteous.
 
Strongly Disagree
 
Somewhat Disagree
 
Neutral
 
Somewhat Agree
 
Strongly Agree
 
 
 
The customer service representative handled my call quickly.
 
Strongly Disagree
 
Somewhat Disagree
 
Neutral
 
Somewhat Agree
 
Strongly Agree
 
 
 
The waiting time for having my questions addressed was satisfactory.
 
Strongly Disagree
 
Somewhat Disagree
 
Neutral
 
Somewhat Agree
 
Strongly Agree
 
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