CUSTOMER SATISFACTION SURVEY FORM

 
BAKAT INDUSTRI SDN BHD
(Co. Reg. No.: 166605-X)
 
Company : Tel. No. :
Attention To : Fax. No. :
From : Date : Pick a date

Dear Customer,

Our goal is to be the best supplier of goods and services to you. As our customer, your constructive comments would be greatly appreciated in order to help us continuously improve our service to you.

Please rate our service by choosing on a scale of 1 to 5 with the highest number representing more satisfaction and "5" being fully satisfied, and the lower numbers representing relatively little satisfaction. "1" means no satisfaction.

 
No.
 Criteria
No Satisfaction -> Fully Satisfaction
A. Timeliness & Reliability of Delivery
1
 On-Time Delivery
1
2
3
4
5
2
 Respond promptly
1
2
3
4
5
3
 Provides accurate info/part/service
1
2
3
4
5
4
 Service is there when needed
1
2
3
4
5
5
 Short lead time
1
2
3
4
5
Sub-total of A
 
B. Quality of Products & Services
1
 Provides 100% quality products/services
1
2
3
4
5
2
 Accepts responsibility of quality works
1
2
3
4
5
3
 Request constructive improvements
1
2
3
4
5
4
 Positive feedback
1
2
3
4
5
5
 Functionality of product
1
2
3
4
5
  Sub-total of B
 
C. Responsive to Customer Needs
1
 Good listener
1
2
3
4
5
2
 Delivers to point of use
1
2
3
4
5
3
 Review changes with customer
1
2
3
4
5
4
 Competitive cost
1
2
3
4
5
5
 Is always there when needed
1
2
3
4
5
Sub-total of C
   
D. Communication with Customer
1
 Communication clear
1
2
3
4
5
2
 Positive attitude
1
2
3
4
5
3
 Understand customer needs
1
2
3
4
5
4
 Develops new idea with customer
1
2
3
4
5
5
 Maintain regular communication
1
2
3
4
5
  Sub-total of D
     
  Total A + B + C + D
 
Comments by customer:
Appraiser's Name :
Appraiser's Position :