SERVICE QUALITY EVALUATION FORM
General
In evaluating your most recent customer service experience, was the quality of service you received:
Please describe if there was any particular aspect of the service experience that stood out:
Very Poor
Somewhat unsatisfactory
About average
Very satisfactory
Superior
The process of getting your problem resolved was:
Please describe if there was any particular aspect of the process that stood out:
Very Poor
Somewhat unsatisfactory
About average
Very satisfactory
Superior
Customer Service Representative
The customer service representative as very courteous.
The customer service representative handled my call quickly.
Strongly disagree
Strongly disagree
Somewhat disagree
Somewhat disagree
Neutral
Neutral
Somewhat agree
Somewhat agree
Strongly agree
Strongly agree
Which of the following qualities of the service representative stood out (as being superior)?
What qualities of the customer service representative irked you?
Patient
Not patient
Enthusiastic
Not enthusiastic
Listened carefully
Didn't listen carefully
Friendly
Unfriendly
Responsive
Unresponsive
Other
Other
No specific quality
No qualities irked me
What would best describe your experience, when you called?
The customer service:
Kept me waiting on hold
Gave me the wrong information
Had to explain several times
Didn't understand the question
Didn't know how to handle problem
Gave unclear answers
Had to ask others
Couldn't solve problem
Spoke slowly
Disorganized
Other
Other
No improvement needed
No improvement needed
The customer service representative was very knowledgeable.
The waiting time for having my question addressed was satisfactory.
Strongly disagree
Strongly disagree
Somewhat disagree
Somewhat disagree
Neutral
Neutral
Somewhat agree
Somewhat agree
Strongly agree
Strongly agree
My phone call was quickly transferred to the person who could best assist me:
Over the next 12 months, how likely are you to replace your (product) with another (product or brand)?
Strongly disagree
Certain
Somewhat disagree
High chance
Neutral
Equal chance
Somewhat agree
Low chance
Strongly agree
Never
Thank you for your feedback. We sincerely appreciate your honest opinion and will take your input into consideration while providing products and services in the future.
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