InfoPoll Survey Sample

Sample - Customer Satisfaction Survey

by your company

Note: Marked with * is required.

Section 1

1.1

Which of the following services do you use?

Service 1	Service 2
Service 3	Service 4
Other

1.2

How would you rate our services in term of ...

	Excellent	Very Good	Good	Fair	Poor
Your Overall Experience:
The Value of our service:
Promptness of our service:
The Courtesy of our staff:

1.3

Any comments or suggestions

Section 2

2.1

How may we reach you? (optional)

Your name:
Phone:
Email:

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