Feedback Questionnaire Format

June 10, 2011

Please take a few moments of your time to give us your feedback. Your contribution is greatly appreciated.

Name (optional):

______________________________________________________________

Title (optional):

______________________________________________________________

Contacts (optional)

______________________________________________________________

Date:

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(Please tick where applicable below)

How effective are our services in terms of

Excellent                   fair                        poor

Speed ______________________________________________________________

Quality ______________________________________________________________

Performance ______________________________________________________________

Pricing ______________________________________________________________

Are our services of any benefit to you?

________________________________________________________________________

________________________________________________________________________

How would you compare us to our competitors?

________________________________________________________________________

________________________________________________________________________

Do you have any suggestions on how we can improve on our service delivery to you?

________________________________________________________________________

________________________________________________________________________

Would you recommend us to your friends, family or colleagues?

________________________________________________________________________

________________________________________________________________________

Which other services would you like us to offer you?

________________________________________________________________________

________________________________________________________________________

How you rate our staff? (Tick where applicable)

10-30%          31-69%             70-89%            90 -99%

Polite ______________________________________________________________

Quick ______________________________________________________________

Attentive ______________________________________________________________

Do you have any other comments?

________________________________________________________________________

________________________________________________________________________

Thank you for completing this feedback.

Download Feedback Questionnaire Format in Word Format

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