Customer Service Feedback Template

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1. Name

2. Age

3. Sex

Male
Female

4. Email address

5. Is there any concern or issue that you would like to raise?

6. How do you rate our services offered?

Excellent
Good
Average
Poor

7. Were your service expectations met?

Yes
No

Comments

8. Please comment on what your expectations are

9. Would you prefer a personalised system of correspondence?

Yes
No

10. Do you have any suggestions that you feel can help us perform better?

11. What has your general experience been with the company?

12. How can this experience be improved?

13. Are you willing to receive our weekly newsletter via e-mail?

Yes
No

14. Do you have any other remarks to make regarding our services and your expectations?

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