Customer Satisfaction Survey

    Hospital Name:

    Your Name:

    E-mail Address:

    Telephone Number:

    1. How likely is it that you would recommend this company to a colleague?

    (0 = Not at all likely > 10 = Extremely likely)

    2. How would you rate our delivery performance?

    Please provide further information:

    3. Which of the following words would you use to describe our products? Select all that apply.

    ReliableHigh qualityUsefulUniqueGood value for moneyOverpricedImpracticalIneffectivePoor qualityUnreliable

    4. How well do our products meet your needs?

    5. How would you rate the quality of the product?

    Please provide further information:

    6. How would you rate the value for money of the product?

    Please provide further information:

    7. How responsive have we been to your questions or concerns about our products?

    Please provide further information:

    8. How long have you been a customer of our company?

    9. How likely are you to purchase any of our products again?

    10. Do you have any other comments, questions, or concerns?

    Would you like any further information on any of our products?

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