SERVICE QUALITY EVALUATION FORM

General
In evaluating your most recent customer service
experience, was the quality of service you received:
Very

Please describe if there was any particular aspe

service experience that stood out:

Poor

Somewhat
About
Very

unsatisfactory

average
satisfactory

Superior

The process of getting your problem resolved was:

Very

Please describe if there was any particular aspe

process that stood out:

Poor

Somewhat
About
Very

unsatisfactory

average
satisfactory

Superior

Customer Service Representative

The customer service representative as very courteous.
Strongly

disagree

Somewhat

disagree

Neutral

Strongly

disagree

Somewhat

disagree

Neutral

Somewhat
Strongly

The customer service representative handled m

quickly.

agree
agree

Which of the following qualities of the service

representative stood out (as being superior)?

Somewhat
Strongly

agree
agree

What qualities of the customer service represen

you?

Patient

Not

patient

Enthusiastic

Not

enthusiastic

Listened

Didn't

carefully

listen carefully

Friendly

Unfriendly

Responsive

Unresponsive

Other

Other

No

No

specific quality

What would best describe your experience, when you

called?

qualities irked me

The customer service:

Kept

me waiting on hold

Had

to explain several times

Didn't
Had

know how to handle problem

to ask others

Spoke

slowly

Gave me the wrong

information
Didn't understand the
question
Gave unclear answers
Couldn't

Disorganized

Other

Other

No

No

improvement needed

The customer service representative was very

knowledgeable.
Strongly
Somewhat

disagree
disagree

Neutral
Somewhat
Strongly

Somewhat

agree
agree

disagree
disagree

Neutral
Somewhat
Strongly

improvement needed

The waiting time for having my question addres

satisfactory.
Strongly
Somewhat

disagree
disagree

Neutral

My phone call was quickly transferred to the person who

could best assist me:
Strongly

solve problem

Somewhat
Strongly

agree

agree

Over the next 12 months, how likely are you to

your (product) with another (product or brand)?
Certain
High
Equal

agree

agree

Low

chance
chance
chance

Never

Thank you for your feedback. We sincerely appreciate your honest opinion and will take your input i
consideration while providing products and services in the future.

RM

as any particular aspect of the

tood out:

as any particular aspect of the

resentative handled my call

omer service representative irked

ng my question addressed was

, how likely are you to replace

er (product or brand)?

will take your input into

Question List
Question
Question
Question
Question
Question
Question
Question
Question
Question
Question
Question
Question
Question
Question

1
1A
2
2A
3
4
5
6
7
8
9
10
11
12

Question List

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:
The process of getting your problem resolved was:
Please describe if there was any particular aspect of the process that stood out:
The customer service representative as very courteous.
The customer service representative handled my call quickly.
Which of the following qualities of the service representative stood out (as being superior)?
What qualities of the customer service representative irked you?
What would best describe your experience, when you called?
The customer service:
The customer service representative was very knowledgeable.
The waiting time for having my question addressed was satisfactory.
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)

Questionnaire Results
Question 1
1 Question 1A
Question 2
1 Question 2A
Question 3
2
Question 4
1
Question 5
1
Question 6
1
Question 7
1
Question 8
1
Question 9
1
Question 10
1
Question 11
1
Question 12
1

0
0

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5)

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ice Quality Survey.

ed automatically.

ng "Data" tab.

e link below:

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