Company Name

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Telephone No

Contact Person

Product Name

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How satisfied are you with the product?  Tick one box below please. 

Satisfied:

Neither satisfied nor dissatisfied:

Dissatisfied:

When you chose to purchase the product, which of the following were the three most important factors in your decision? Tick three boxes below please.

Price:

Product features:

Stock availability:

Company reputation:

Relationship with sales personnel:

Please specify your satisfaction level with our sales representatives/agent 
with regard to:

Neither satisfied nor dissatisfied

Timeliness of response to your inquiries

Frequency of contact to satisfy your needs 

Frequency of contact to provide information about new products or services

Product knowledge 

Understanding your needs

Ability to resolve your problem 

Professionalism